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MALDEN HEALTH SERIES 

COMMUNITY 

HEALTH 

_ y'-‘ BY 

C. E. TURNER, M. A., Dr. P. H. 

PROFESSOR OF BIOLOGY AND PUBLIC HEALTH, MASSACHUSETTS 
INSTITUTE OF TECHNOLOGY; ASSOCIATE PROFESSOR OF PUBLIC 
HEALTH AND HYGIENE, TUFTS MEDICAL AND DENTAL 

schools; director of health education studies 

AT MALDEN, MASSACHUSETTS; AND CHAIRMAN OF 
THE HEALTH SECTION, WORLD FEDERATION 
OF EDUCATION ASSOCIATIONS 

AND ,o. 

GEORGIE B. COLLINS 

% 

DIRECTOR OF HEALTH EDUCATION, MALDEN, MASSACHUSETTS 



D. C. HEATH AND COMPANY 

BOSTON NEW YORK CHICAGO 

ATLANTA SAN FRANCISCO DALLAS 

LONDON 







Copyright, 1928, 

By D. C. Heath and Company 

2 e 8 


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PRINTED IN U.S.A. 

JUL "5 B28 

©Cl S1082394 


PREFACE 


This book, like the others in this series, has been 
produced in the classroom by presentation, adaptation, 
revision, re-presentation, and further modification. It 
presents both the social and the personal aspects of com¬ 
munity health. Its place is in the seventh or eighth 
grade, where the child begins to give considerable atten¬ 
tion to the subject of civics. 

The historical approach — which presents the health 
problems of early settlers in America, the difficulties of 
those pioneers who undertook the western migration, 
the development of rural life, and finally the development 
of urban life — has many advantages. It provides a 
natural presentation of country as well as city health 
problems, of rural as well as municipal sanitation. It 
presents a perspective of the changes in the mode of 
living during the last few generations, and, what is per¬ 
haps more important, it allows the pupil to see the origin 
and need of town and city government in the mainte¬ 
nance of health. 

The health-education program at this grade level re¬ 
gards continued training in the habits of healthful living 
as a primary objective. Many subjects and school ac¬ 
tivities should contribute to this end. It is often as diffi¬ 
cult for a child to maintain a specific habit at this age as 
it was for him to establish the habit at an earlier time. 
The Appendix presents suggestions for the organization 
iii 


IV 


PREFACE 


of both class and school activities in the furtherance of 
positive health and the health-training program. 

The authors express appreciation of the continued 
cooperation of the School Board of the City of Malden 
and the Department of Biology and Public Health of 
the Massachusetts Institute of Technology. Particular 
thanks are due Superintendent F. G. Marshall and the 
principals and teachers in those junior high schools in 
which were developed the varied experimental methods 
and approaches from which, by the selection of the best, 
this course of study was gradually evolved. 

Grateful acknowledgment is also made to Professor 
F. B. Dresslar of George Peabody College for Teachers, 
in Nashville, Tennessee, to Mrs. Florence Hobson, 
teacher of hygiene at the Fairmount Junior High School 
of Cleveland, Ohio, and to Miss Effie Knowlton, Director 
of Health Education in Binghamton, New York, who 
read the manuscript and made many constructive sug¬ 
gestions. We also acknowledge the courtesy of the 
Walker-Gordon Laboratories, in allowing us to use sev¬ 
eral pictures of sanitary milk production, and the kind¬ 
ness of the various national organizations and agencies 
through which desirable illustrations were secured. 

People who have used the Malden Health Series have 
already made the acquaintance of our artist, Mrs. Hazel 
Ives. The authors feel that her contribution to the value 
of the book is a large one. 


C. E. T. 
G. B. C. 


CONTENTS 


CHAPTER PAGE 

I. Health . i 

II. A Pioneer, Family .n 

III. The Health of a Large Community .... 18 

IV. Water Supply.24 

V. Wholesome Food.41 

VI. Alcohol, Tobacco, and Other Harmful Sub¬ 
stances .61 

VII. Waste Disposal ..77 

VIII. Other Problems of City Housekeeping ... 94 

IX. Keeping People Well.108 

X. Ventilation.126 

XI. Infant Welfare.139 

XII. The Health Department .148 

XIII. Safety.170 

XIV. The City Provides Recreation.184 

XV. School Health.197 

XVI. The Health of the Worker.211 

Appendix.230 

Index.255 

v 






















COMMUNITY HEALTH 


I 

HEALTH 

What fun it would be to live for a little while in the 
land of long ago! How should you like to have been a 
boy on a Western ranch, or a girl on a beautiful Southern 
plantation, seventy-five or a hundred years ago? Per¬ 
haps you would like to have lived the care-free life of an 
Indian child in the time before the white men came. 

The ways of life were much simpler in those days than 
they are now. The pioneer boy ate rough natural foods. 
He lived largely out of doors, playing or helping to pro¬ 
vide food and shelter. His play was in the woods or 
about the yard. He was likely to go to bed early, be¬ 
cause his cabin was so poorly lighted that there was little 
to do after dark, and he had played or worked so vigor¬ 
ously all day that he was too sleepy to stay up late. 

One may say that life was more “ natural ” in those 
days. People ate the kinds of foods which nature pro¬ 
vided, used their bodies in active exercise, lived in the 
open, and found rest in long hours of refreshing sleep. 
How different is life today! We eat highly refined foods 
which man has learned to manufacture from nature’s 


2 


COMMUNITY HEALTH 


bounty; we live in heated houses; most grown-ups ex¬ 
ercise very little — many people actually sit still all day 
at their desks; we turn night into day with electricity, 
while countless activities beguile us into spending the 
late evening hours at things other than sleep. If one 
says that life in the pioneer days was simple and natural, 
he may say that, in contrast, the life of today is complex 
and artificial. 

What bearing does all this have on the matter of 
health? You may know that animals require special 
care when they live under artificial conditions. Other¬ 
wise they are ’likely to suffer from illnesses or defects 
which they would not develop under their natural ways 
of living. In a book entitled The Ways of the Circus 
there is an interesting description of the care of caged 
lions. The trainer says he does not give them fat meat, 
because it will cause boils. He never gives them meat 
without bones, because they will swallow the meat whole 
and become ill from indigestion. He is careful not to 
overfeed them, because that makes them lazy and in¬ 
active. If these lions were living in the jungle, there 
would be no need to worry about their feeding. They 
could use what little fat meat they got, because they 
would have so much exercise. They would never have 
meat without bones, and would always be obliged to tear 
it in shreds before swallowing it. They would not be in 
danger of overfeeding, because food is scarce in the jungle 
and they would need a great deal of nourishment to sup¬ 
port their active lives. 


HEALTH 


3 



We, living under present-day conditions, are somewhat 
like the lions in the cage. Highly refined foods and lack 
of exercise are among the common faults in our scheme 
of life. We must regulate our habits if we wish to keep 
our bodies in good health. 

Health and hygiene. — The maintenance of health is 
based upon the study of hygiene. If you look up the 
words in the dictionary, you will see the difference be- / ~ 
tween the meaning of u hygiene ” and the meaning of 
“ health.” “ Health ” is a condition of the mind and 
body, whereas “ hygiene ” is the science of gaining and 
preserving health. 

The Italian Institute of Hygiene has as its motto the 


































































4 


COMMUNITY HEALTH 


following definition: “ Hygiene tends to make growth 
more perfect, decline less rapid, death more distant, and 
life stronger and happier.” How many things may hy¬ 
giene do for us according to this definition? Will every¬ 
body profit in all of these ways from a study of health 
and hygiene? 

In your dictionary study of the word “ health ” you 
will find that it is related to the word “ whole.” Imme¬ 
diately your mind says: “ How fitting! That which is 
healthy is wholesome! ” Indeed, the word “ wholesome ” 
describes beautifully the type of person who has abun¬ 
dant health of body and of mind. Who would not choose 
to be one of this type — good to look upon, cheerful in 
disposition, intelligent, alert, honest, reasonable in be¬ 
havior, and capable in work? Such a person is a delight 
to family and to friends. 

Value of health. — You can think of countless reasons 
why you desire for yourself such a state of health, or 
“ wholesomeness,” as that just described. Make a list 
of the reasons why health seems desirable to you. Com¬ 
pare the various lists from your class and put together a 
complete list of all the reasons given. Which reasons are 
most important? 

Health is not only a condition of the body; it is equally 
a condition of the mind. Mind is the gift which sets man 
apart from the lower animals. Man, therefore, sets 
greater stress upon the things which have to do with the 
mind than upon those which have to do merely with the 
body. The highest reasons for desiring health are those 


HEALTH 


5 



HEALTH GIVES ZEST TO SPORT 


which have to do with the development of mind, char¬ 
acter, and the opportunity for usefulness. We want 
health in order that we may be finer men and women; 
that we may make the most of what nature has given 
us in mind and body; and that we may enjoy life to the 
fullest. 

Do you sometimes think: “ When I am grown up, I 
shall do this, or that, or the other ”? You dream of im¬ 
proving the world. Each one has the right to give some¬ 
thing to the world. Is not each individual a person of 











6 


COMMUNITY HEALTH 


importance? No one should neglect the opportunity to 
acquire the greatest possible perfection of body and mind. 

Signs of health. — Perhaps you ask: “ How does one 
know when he has health? And what does one do to 
possess it? ” Why do you not work together as a class 
to make up a list of the ways in which you can observe 
health in yourself or in other people? Good posture, 



WATCH YOUR GROWTH; IT IS A SIGN OF HEALTH 

















































HEALTH 


7 


clear eyes, a clear skin, vigor of voice — these are some 
of the signs of physical health. What things are to you 
the signs of mental health? You may start your list with 
cheerfulness, honesty, and concentration. What other 
qualities can you add? 

One of the most important signs of physical health in 
boys and girls is growth in height and weight. How 
much have you gained in the past year? How does your 
own gain compare with that of other boys or girls of your 
own age? How does it compare with the average for 
boys or girls of your age as given in the Bald win-Wood 
tables? (See Appendix, pages 253 and 254.) 

You are now at the age of most rapid growth. You are 
no longer children; you are becoming young men and 
young women. During this time of rapid development 
in which you are changing from child to adult, you need 
to direct your ways of living carefully so that you may 
help yourself to realize the ideals of life and service of 
which you dream. Your physical condition five years 
from now is in your own hands more completely than 
most of you realize. The time for building a house se¬ 
curely and beautifully is during the building time — not 
after the house is completed. The time for building a 
strong and beautiful body is during the time of develop¬ 
ment. Indeed, no amount of patching-up later in life can 
wholly make up for what you fail to do now. 

How does one secure health? — A boy becomes a good 
baseball player by playing baseball. One becomes gifted 
with health by playing the health game. There are some 


8 


COMMUNITY HEALTH 


disagreeable things about learning to play baseball, but 
the fun more than makes up for them. There are some 
sacrifices to be made in playing the health game, but the 
satisfaction and joy which come with the possession of 
health more than offset them. In the health game, as in 
baseball, one must play with persistence and with hon¬ 
esty; one must keep the rules. One reason why the 
health game is particularly fascinating is that every one 
who plays can improve his score. 

The rules of the game you know. Here they are as set 
down by the American Child Health Association: 

1. A full bath oftener than once a week. 

2. Brushing the teeth at least twice every day. 

3. Sleeping long hours with the windows open. 

4. Drinking as much milk * as possible, but no coffee or tea. 

5. Eating some vegetables every day. 

6. Drinking at least four glasses of water a day. 

7. Playing part of every day out of doors. 

8. A bowel movement every morning. 

Add more rules and try to arrange them in the order 
of their importance as related to health. Check for your¬ 
self the ones which you can honestly say you have trained 
yourself to keep regularly. Look over the other rules and 
decide which ones you will attack immediately. Get into 
training and play the game! 

This ought to be an important part of your health 
work this year — just playing the game of health. Most 
people like to do things better when they work with 

* Nutrition experts recommend a quart a day. 


HEALTH 


9 


others than when they work alone. Should you not like 
to organize your class in some way so that all of you may 
undertake your training in health together? Since your 
particular study for this year is the health of the commu= 
nity, you may like to imitate the Board of Health or 
Health Department in the city government and organize 
your personal health work under a Board of Health in 
your class. In the Appendix you will find suggestions 
for such an organization and for activities which you can 
carry on at different times during the year. 



HEALTH IS A STEPPING-STONE TO SUCCESS AND HAPPINESS 


Your health program. — Your program of health work 
for the year, then, is divided into two parts: first, a con¬ 
stant effort to attain for yourself the best standards of 
growth and development; second, an advance in your 
















IO COMMUNITY HEALTH 

knowledge and understanding of present-day problems 
through your study of community health. You may use 
alternate lessons for personal health activities and for the 
study of community health, or you may make some other 
arrangement which your teacher thinks better. In study¬ 
ing community health do not forget that the first health 
duty of a good citizen is to be healthy himself. 

Every girl wants to be well and attractive; every boy 
wants to become strong and vigorous — nature intends 
that they should. Everybody desires to succeed. Is 
there not opportunity for all? You who would be attrac¬ 
tive, you who would be strong and vigorous, you who 
would succeed — seek health! Health is what nature 
gives you plus what you give yourself. How much are you 
willing to give? 


II 


A PIONEER FAMILY 


Do you know: 

How the life of the pioneer differed from your own? 

How the early settlers safeguarded their health? 

What precautions were necessary in order to protect the family? 

What problems the modern farmer has in keeping a healthful 
home? 

You are all familiar with stories of the covered wagons 
by which families traveled from the towns of the East to 
make their new homes in the West. One may picture a 
family consisting of a man, his wife, and their children 
— perhaps a boy of sixteen, a girl of thirteen, and several 
younger children — all sharing this experience of travel¬ 
ing several hundred miles to a new settlement in a new 
and unknown land. 

Usually they led their cows along with them in order 
to have milk. They might even carry two or three little 
pigs and some hens. Sometimes they would kill one of 
these animals for fresh meat, but usually the shotgun or 
rifle provided this part of the meal from the wild game 
along the way. A shepherd dog was always a good com¬ 
panion on the journey because he would care for the sheep 
and guard the camp. When the family reached the sec¬ 
tion where they expected to settle, the man staked out a 


ii 


12 


COMMUNITY HEALTH 


claim, for the land belonged to the government and was 
given in certain amounts to people who would settle on it. 

The building site, — The first problem was to choose 
the site for building a house. A prime consideration in 
this selection was the question of water supply, because 
water is a necessity for life. In some sections good 
springs were found, and these determined the location of 
the home. In some cases wells were dug. In constructing 



THE PIONEER FAMILY SOUGHT A NEW HOME 






















A PIONEER FAMILY 


!3 


a well the wise settler chose a place higher than the land 
where the house was built, or so located that no waste 
could drain into it. When completed, the well was walled 
with stone and tightly covered so that hens, dogs, or 
people moving about at the top of it could not scatter 
dirt into it. The careful man thus had drinking water 
which was pure and a well that could be kept clean. 

Another consideration in choosing the location of the 
home was the nature of the soil. The cabin would be 
placed on high rather than marshy land. Thus the set¬ 
tler’s family would be assured of a home that was dry and 
removed from mosquito-breeding pools. The man who 
built on a rise of land in gravel soil was very fortunate, 
because gravel drains easily and is good land in which to 
put the underpinning or foundation for a house. He was 
fortunate, too, if his house was built so that the sun shone 
upon the long side, making the rooms pleasant and dry 
and helping to warm the house in winter. 

Domestic animals. — The pioneer’s next step was to 
build a stable for the domestic animals — a barn or lean- 
to or shed. He used hay or straw for bedding. He built 
a pen for the pigs and a coop for the hens. These animals 
were useful to the family, not only in furnishing food, but 
also in using up the kitchen waste. 

The wise man was careful about the cleanliness of his 
cows and the methods of milking. The milk was cooled 
quickly by hanging the milk pails in the well or setting 
the pans of milk in the cellar. All milk was kept in a clean 
place where dirt could not get into it. 


14 


COMMUNITY HEALTH 



The sensible man knew also the importance of using 
only healthy animals for food. Sick animals were killed 
and buried in the woods; meat from these animals was 
not eaten. The meat supply was supplemented by buf¬ 
falo, hunted on the plains, or bear and deer from the 
highlands. With his gun the settler shot down vigorous, 
healthy animals. He bled them properly, dressed each 
creature, and carried home a larger piece of fresh meat 
than we ever buy at the market. 

Crops. — In the spring he planted a vegetable garden, 
in clean, fertile soil, at a place where there was no drain¬ 
age from the barn or toilet. He raised many vegetables, 
for they were an important part of his food supply. In 
the summer the garden supplied fresh lettuce, spinach, 
beet greens, corn, string beans, and cucumbers. In the 
fall it furnished potatoes, carrots, turnips, cabbage, 


GRINDING CORN BY HAND 




























A PIONEER FAMILY 


15 


onions, and other vegetables to be packed away in a dry 
place for use in winter. 

The settler raised his own corn and wheat, too. Some¬ 
times he carried the whole grain to some place at a dis¬ 
tance, where he had it ground into coarse meal and flour; 
sometimes he himself ground it by hand or in some crude 
grinding machine. All the food supply for the family 
was raised by the settler himself, and he could guarantee 
its quality. 

Wastes. — There was always the problem of disposing 
of wastes from the house. The food waste was fed to 
pigs and chickens, so that it was promptly taken care of 
without creating a nuisance. There was a sink spout to 
take the waste water away from the kitchen. If the set¬ 
tler was fortunate enough to be able to cut his own ice in 
winter and store it for summer, there was an ice k chest 
which had to be drained by a pipe. The water from the 
washtubs was carried a little way from the house and 
poured on the ground. There was no bathroom, of 
course, and the washtubs served as bathtubs once or 
twice a week. The waste water from the house was car¬ 
ried far enough away so that it would not cause odor 
or dampness. It was frequently poured over a pile of 
rocks or upon light gravel soil in a sunny place in 
order that the water might be dried up and purified by 
nature. 

The pioneer was obliged to build an outdoor toilet, or 
privy, because he had no running water supply for a 
bathroom. One way of building such an outhouse was 


i6 COMMUNITY HEALTH 

to dig a deep pit in the ground. He covered the pit 
tightly so that animals and flies could not get in. He 
kept the contents of the pit dry by using sand or dry 
dirt. Such an outdoor toilet was quite satisfactory. The 
manure from the stable was disposed of by spreading it 
on the land, where it would become part of the soil. 

Keeping well. — Families living in the wilderness were 
not worried about measles or scarlet fever, or any such 
illnesses. The children played only among themselves, 
for there were no other children near enough to play with 
them. Unless they all went into town for a county fair 
or a rodeo, they were not likely to catch any communi¬ 
cable diseases, because there was no one from whom to 
catch them. 

In the life of the pioneer all of these various health 
problems were, for the most part, under his own control. 
In order to raise good crops and healthy animals, and to 
take good care of his family, he had to meet these health 
problems. Of course some men were wiser than others, 
and consequently provided more successfully for their 
families. Some were more fortunate, and happened to 
make choices which were favorable to health. You can 
easily imagine that a stupid man would fail at pioneering. 
Only the intelligent and industrious man could bring up 
a family safely in the wilderness. 

Select from this story of the pioneer the things which 
are related to health and write them down on paper. 
When we start to study community health we are con¬ 
fronted by many of these same problems. Most of us do 


A PIONEER FAMILY 


17 


not live on ranches or farms where the control of things 
is in our own hands. We live in towns or cities and must 
meet these problems in a different way. 

Problems and Projects 

1. Make a list of all the conditions related to health which are 

mentioned in this chapter. 

2. See which conditions are mentioned most frequently in your 

classmates’ lists. Are they the most important? 

3. Discuss the way these problems are met at your home or at 

some farm or camp where you have been. 

4. Answer the questions at the beginning of this chapter. 


Ill 


THE HEALTH OF A LARGE COMMUNITY 

How much money is spent for health each year in your town or 
city? 

How much is this per person each year? 

For what things is this money spent? 

Could the taxpayers of your town or city do these things for 
themselves on the same amount of money? 

What health problems are found in cities but not in the country? 

Have you ever read Robinson Crusoe or Swiss Family 
Robinson? In these stories there were no problems of 
government. So it was with the pioneers, for their homes 
were far apart. But as others came, settling nearer and 
nearer, communities were formed. Then common in¬ 
terests developed, common difficulties appeared. Local 
government was established. 

As you study civics you learn the purpose and nature of 
government. You may have thought of it as a means of 
having things done for the people. See if your class can 
agree upon a definition of government. 

Government. — In the Declaration of Independence 
of the United States there is this statement of the rights 
of people in government: “ We hold these truths to be 
self-evident: That all men are created equal; that they 
are endowed by their Creator with certain unalienable 

18 


THE HEALTH OF A LARGE COMMUNITY 19 

rights; that among these are life, liberty, and the pursuit 
of happiness.” These, then, are the recognized rights of 
each human being: life , liberty , and the pursuit of 
happiness . If one lives alone, like Robinson Crusoe, no 
one interferes with these rights, but when people live in 
towns or cities it is fairly certain that some will not regard 
the rights of others. Some system of government must 
be formed. 

Each person is guaranteed personal liberty, but if he 
goes beyond his rights and interferes with others the reg¬ 
ulations of government compel him to stop. What is 
meant by the sentence: “ Personal liberty ends where 
the acts of the individual interfere with the public 
welfare ”? 

You may ask whether health is part of these “ unalien¬ 
able rights ” under government. Is health an important 
part of life? Surely we are more concerned over the loss 
of health than over the loss of money. Is health related 
to happiness? It is possible, of course, to have a large 
share of happiness without health, but health is a decided 
aid in the search for happiness. 

One duty of government, then, is to protect the health 
of each citizen. Another function of government is serv¬ 
ice — that is, doing things for the people. For example, 
education is provided for all the children of the commu¬ 
nity. Would it be practicable to hire a separate teacher 
for the children of each family? It would be very expen¬ 
sive even in a family with three or four children. 

The Swiss Family Robinson had to build their own 


20 


COMMUNITY HEALTH 


roads. What a burden it would be if we had to build a 
road to wherever we wanted to go! It is easy to see that 
the best way to have good roads is for people to join to¬ 
gether and pay for having them built. In the city there 
is a Street Department. We pay money through taxes, 
and this department builds better roads than we ourselves 
could build. 

Health problems. — In the country a man either keeps 
a cow himself or buys milk from a neighbor. He can 
visit his neighbor’s barn and see for himself how the milk 
is handled. Most of you get your milk from a milk 
dealer; you cannot go to the farms where the cows are. 
Your government accepts the responsibility of seeing 
that the milk is pure and clean. 

How many of you get water from your own well? How 
do you know that the water is pure? In using a city 
water supply, you cannot see where the water comes 
from. You rely upon your government to safeguard the 
water supply. 

Do any of you keep pigs and kill them for pork in the 
fall? How many of the families represented in your class 
raise chickens? Most of us have to buy meat which 
comes from a distance. We cannot see for ourselves thdt 
it comes from healthy animals. 

How many of you buy bakery food? Perhaps you 
could go into the bakery kitchen and see how the food is 
cooked, but you are not likely to do so. Some one from 
the Health Department makes sure that the food is clean 
and wholesome. 


THE HEALTH OF A LARGE COMMUNITY 


21 



It is quite clear that you and I should be in danger 
unless some one did these things which are necessary to 
safeguard our health. The branch of the government 
which does this work is the Board of Health or Health 
Department. 

If you review the things which are important in main¬ 
taining the health of the home, you will see that there 















COMMUNITY HEALTH 


22 ' 

are similar problems in keeping a city clean and well. 
Look over the following list of problems which have to 
be met in both country and city. Discuss the way these 
problems differ in the country and in the city. 

Problems of Cleanliness 

1. Securing clean and wholesome food. 

2. Securing clean water. 

3. Providing sewage disposal. 

4. Removing ashes, rubbish, and kitchen waste. 

5. Avoiding dust and smoke. 

6. Preventing rat nuisance, mosquito nuisance, and fly nuisance. 

7. Securing proper bathing facilities. 

Problems of Disease Prevention 

1. Providing immunization against smallpox, diphtheria, and 

some other diseases. 

2. Preventing the spread of disease. 

Problems of Providing Recreation 

1. Giving opportunity for games and sports. 

Problems of Comfort 

1. Securing comfortable housing. 

2. Securing proper heating and ventilation in public buildings. 

3. Securing proper lighting in public places. 

Problems of Safety 

1. Control of fires. 

2. Control of traffic. 

3. Police protection. 

In addition to the health problems which exist in both 
the country and the city, there are certain problems 
which are peculiar to the city alone. There is, for ex¬ 
ample, the problem of city planning. A well-arranged 


THE HEALTH OF A LARGE COMMUNITY 


23 



A TYPICAL GROUP OF CITY BUILDINGS 


city cannot grow up without a plan any more than a good 
house can be built without one. The streets must be laid 
out properly. Some cities have made a wise provision 
by planning for the kind of building to be done in differ¬ 
ent parts of the city. One section of the city is set aside 
for factories and large business buildings, while another 
part is set aside for homes. Such a plan is usually called 
a Zoning System. 

To maintain the health of a large community is a com¬ 
plex problem. In meeting this problem there is a double 
responsibility: (1) that of the city government to render 
sound, scientific, faithful, and honest service; (2) that of 
all citizens to give loyal and intelligent support. Will 
you do your part? 

Problems and Projects 

1. Why is it worth while to spend tax money upon health? 

2. What divisions in the city government do things which are 

related to health? 

3. What kinds of health work does your city do? 



IV 


WATER SUPPLY 

Is life possible without water? 

How is it possible for mold spores to stay alive in dry dust? 

Is there any plant or animal which can grow without water in 
some form? 

What are the uses of water on a farm? 

What are the uses of water in a city? 

What would happen in the place where you live if there were no 
water for two weeks? 

What kind of water is necessary for drinking purposes? 

How much water does your city use each day? 

How does a big city get a satisfactory supply of drinking 
water? 

Importance of water. — Water is a necessity for health. 
Indeed, nothing can live without it. The body itself is 
about two-thirds water; the soft parts of the body, like 
muscle and brain, are three-fourths water. Every living 
thing contains a high percentage of water. 

Spores of mold can stay alive in dry dust because a 
thick wall is formed around the living substance. This 
wall prevents the small amount of water from drying out. 
Mold plants cannot grow, however, until a spore gets back 
to a place which is warm and moist. You have noticed 
how grass and flowers freshen up and grow when there 
has been rain for a few days. Abundance of water is one 

24 


WATER SUPPLY 25 

of the first essentials for maintaining a healthy plant or 
animal. 

“ Drink at least four glasses of water a day ” is one of 
the first health rules you learned to practice. By now 
you have probably increased the amount to six glasses or 
more each day. You have learned that the circulation of 
fluids in the body is one of the most important activities 
which go on in the human mechanism. These fluids 
bring food and oxygen to the tissues and carry away the 
waste products. You have seen the importance of water 
to good digestion and proper use of food by the body. 
It has been shown that man can live for a month or more 
without food, but he can live only a few days without 
water. Have you ever read tales of men lost in the 
desert, without water, or afloat in a small boat at sea 
without fresh water to drink? 

The farmer knows that he must have a good supply of 
water for his animals, as well as water in the land to make 
the crops grow. In the city, water is used in hundreds of 
different ways. It is used for cleanliness about the home, 
to water the lawn, to wash the streets, to put out fires, to 
supply power for mills, and to help in many kinds of man¬ 
ufacturing processes. You could prepare a rather long 
list of the particular uses for water which you have seen 
in your own town or city. 

Selecting a water supply. — Every pioneer in the early 
days made sure of a good water supply before he started 
to build his house. How utterly foolish it would be for 
a man to say that only a few quarts of water a day were 


26 


COMMUNITY HEALTH 


needed for drinking, and that it could be brought to the 
house from some distant place. Unless water is close at 
hand and easy to secure, there is danger that people will 
not drink enough to maintain perfect health; and cer¬ 
tainly proper cleanliness is difficult to secure when the 
supply is scanty. 

What quality of water does the pioneer try to secure? 
Does he wade out through the mud and grass of a swamp 
until he is knee-deep in water, and then put down a pipe 
through which he can pump? You recognize this as a 
silly procedure, of course, but do you know the exact 
reasons why such a water supply would not be good? 

In the first place, swamp water is usually yellow or 
greenish in color; it may even be somewhat blackened 
if the soil of the swamp is very dark. You can easily see 
that water which is colored is neither attractive to drink 
nor practicable to use for bathing and laundering. The 
color of swamp water comes from plants which have been 
soaking in the water and from the muddy soil. This 
color is not injurious to health, but it makes the water 
undesirable. 

Standing water is often green in color, not from the 
/ large green plants which have been growing in it, but 
from tiny green plants which are floating there. These 
plants, which are called algae, are so small that they can¬ 
not be seen except through the microscope. They are as 
harmless as grass, and it probably does us no more harm 
to drink water in which there are algae than to eat a very 
thin vegetable soup. The greenish color is unattractive, 





WATER SUPPLY 


27 


however, and frequently there is an unpleasant odor. 
When water contains plenty of dissolved food material 
for these plants they grow in sunlight with great rapidity 
until there are thousands 
of them in every cupful 
of water. There is one 
variety of alga which has 
an odor like a rose gera¬ 
nium; another which has 
a rather grassy odor; 
others have odors not so 
pleasant. In looking for 
a water supply, there¬ 
fore, we should avoid 
water from a swamp, 
because such water is 
likely to have a disagreeable color, taste, and odor. 

We should also avoid water which is roily. Have you 
ever seen roily water? Shallow water is so much dis¬ 
turbed by a hard rain that particles of mud are picked 
up by it. Such water is said to be roily, or turbid. River 
water often picks up mud. The Mississippi is spoken of 
as a turbid river. 

Sometimes there are traces of iron in the soil which 
give the water an iron taste like that of water which has 
run through new iron pipes. Iron may also give a cloudy 
yellow color and leave rust spots on clothes when they 
are washed. 

The pioneer, or settler, would refuse swamp water 



MICROSCOPIC GREEN PLANTS 
IN WATER 


28 


COMMUNITY HEALTH 


because of its temperature. In a northern climate the 
whole swamp would freeze in winter. In warm weather 
swamp water would be unsatisfactory, too, because it 
would be so warm that no one would like to drink it. 

Water is likely to contain harmful bacteria if it is lo¬ 
cated where body wastes from men or animals may drain 
into it. The pioneer would be in little danger of finding 
polluted water, however, because he would be in a loca¬ 
tion practically uninhabited. 

In selecting a water supply one would look for a spring 
of clear water bubbling up out of the cool ground of a 
hillside, or dig a well to bring up the clear, cool water 
which is slowly moving through the ground at some dis¬ 
tance below the surface. This water has soaked through 
from the surface, of course, but it has been purified by 
filtering slowly through the deep layers of the clean earth. 
It is cool, clear, and tasteless. 

Springs and wells may not always remain safe, how¬ 
ever, unless properly protected. In the first place, a 
spring or well should be located in such a way that dirt 
from the toilet or stables will not run into it. A well 
should be properly built, so that it is protected from all 
kinds of surface drainage. The top should be surrounded 
with a layer of cement or concrete which extends into 
the ground for a short distance. The covering on top 
of the well should be tight. Wells which are not properly 
built are open to pollution, and frequently such wells 
are the means of spreading disease. Springs need to be 
protected, too, if their purity is to be maintained. A 


WATER SUPPLY 


29 


spring may be covered with a boxlike structure which 
has a pipe through which the water may run. 

Water from springs or wells ought not to be too hard. 
In soaking through the ground, water sometimes picks 
up mineral substances which change it from soft water 
which fell upon the ground as rain to a very hard water, 
with which one must use a large amount of soap in 
washing. What experience have you had with hard and 
soft water? 

Sometimes a farmer brings water from a spring on a 
hill directly into his house. He is careful to use a gal¬ 
vanized iron pipe to keep the water pure, for long lead 
pipes would poison the water. 

Qualities of good water. —The questions which the 
pioneer or the farmer asks in regard to good water are 
the same ones that you need to consider if you are secur¬ 
ing a water supply for a camp in which you expect to 
spend the summer. Indeed, they are essentially the 
same questions that a city must ask in selecting its 
water supply: 

1. Is the water free from color? 

2. Is the water clear — that is, free from suspended matter like 

sand or clay? 

3. Is the water free from odor? 

4. Is the water free from iron? 

5. Is the water cool? 

6. Is the water soft enough? 

7. Is the water free from lead or other poisons? 

8. Is the water free from waste material which may contain 

germs of communicable diseases? 


30 


COMMUNITY HEALTH 


City water supplies. — It is not easy to get a satis¬ 
factory water supply for a big city because the city 
needs not only the right kind of water but also a tre¬ 
mendously large amount of it. Sanitary engineers who 
plan city water supplies provide water for American 
cities on the basis of a hundred gallons a day for every 
person in the city. We do not actually require one 
hundred gallons each for personal use, of course. Large 
amounts are used about the house, in factories, in putting 
out fires, and in sprinkling streets or cleaning them. How 
much water is needed per day for your city? 

The city, like the pioneer, must choose between a 
surface water supply from rivers, streams, or lakes, and 
a ground water supply from large, deep wells. Occa¬ 
sionally a city may be fortunate enough to have an 
ideal water supply near at hand. Back in the hills 
somewhere, there may be lakes of clear water which are 
fed by springs and by drainage from hillsides where no 
one lives. The water falls as rain upon the hillsides and 
soaks into the ground, making its way through sand or 
gravel down to the lakes. In moving through the ground 
the water leaves all of its dirt behind and comes to the 
lakes clear and cold. From these natural reservoirs it 
flows downhill to the city, where it is distributed to 
houses and factories. 

As a city grows and the country about it becomes 
more thickly settled, the^e is greater difficulty in securing 
a safe and sufficient water supply. New York brings 
part of its water supply from the Catskill Mountains, 


WATER SUTPLY 


3 1 



a distance of many miles. In many places the only 
water available is soiled with the wastes from houses and 
factories. There are various ways of purifying water 
supplies. 

Water purification. — The most dangerous substances 
likely to be in a water supply are those which come from 
the wastes of the human body, because they contain 
bacteria from the intestinal tract. Water which has been 
soiled by the entrance of body wastes is said to be 
polluted. It is easy to see that such water must be 
purified before it can be used as a drinking-water supply, 
If typhoid fever germs get into water, from the body 
wastes of a person who has typhoid, they may live in 


WATER MAY BE PURIFIED BY STORAGE IN A RESERVOIR 

(Reproduced from State Sanitation, by G. C. Whipple, by courtesy of the 
Harvard University Press) 






32 


COMMUNITY HEALTH 


the water long enough to pass through the pipes into the 
houses of the city and thus endanger the lives of people 
who drink the water. Water which contains disease 
germs is said to be infected. The water in a city supply 
may be a little warm, or colored, or muddy, and yet not 
be actually dangerous, but it must always be free from 
disease-producing bacteria. 

One of the ways in which water may be purified is by 
storage. When water stands for many weeks in a lake or 
a large reservoir the dirt and harmful bacteria settle to 
the bottom. Thus the water purifies itself by dropping 
its dirt or pollution. 

Another means of purification which is used by many 
cities is the process of slow sand filtration. The water 
runs through filters of fine sand. These strain out the 
dirt and bacteria, producing a supply of water which 
is clean, sanitary, and entirely satisfactory. 

This filtering process is extremely interesting. If we 
were going to filter water for a city, we should have to 
build boxlike filters perhaps an acre in area. We should 
make concrete floors and tight concrete or brick walls at 
the sides. Along the floors we should have drain pipes 
with many openings. A layer of big rocks would be 
placed above the drain pipes to prevent the sand from 
plugging the small openings. Then smaller rocks would 
be added, then gravel, and finally sand, on top. Then 
we should run water in at the top and let it filter through 
the sand; the purified water would be carried away 
through the drain pipes at the bottom. 


WATER SUPPLY 


33 



The dirt in the water is held back by the sand. The 
bacteria are smaller, however, and could get through 
between the grains of sand as easily as you could go 
between two houses, were it not for the fact that another 
process goes on here. All the sand at the top of the filter 
becomes covered with useful, harmless bacteria which 
stick there, because they produce a kind of jelly as they 
grow. The sand grains fit together fairly closely, of 
course, and you can imagine what the top of the filter is 
like when these grains are each enlarged by a layer of 
bacterial jelly. If we should wash some of the sand in 
water, and examine this water under a microscope, we 
















34 


COMMUNITY HEALTH 


could see some of the bacteria which are living on the 
sand grains producing the jelly covering. 

The jelly like substance helps to fill up the holes be¬ 
tween the sand grains. Its stickiness is an advantage, 
too; for dirt and bacteria in the water stick to the jelly 
more easily than to clean sand. If there are harmful 
bacteria in the water, they are caught and held at the 
top of the filter. 

There is one other kind of filter which is commonly 
used, the mechanical filter. It makes use of a chemical 
process which partly purifies the water before it is filtered. 
Do you know what is meant by mixing two liquids to¬ 
gether so that a precipitate is formed? Have you ever 
seen a mixture of liquids where flakes are formed in the 
mixture? Two liquids, made by dissolving lime and 
alum, are added to the water. These unite to form little 
flakes which settle down to the bottom, carrying the 
dirt and bacteria with them, just as snowflakes clean the 
air in a snowstorm. The clean water is then passed 
through a small sand filter. 

In this mechanical sand filter no bacteria grow on the 
top of the sand. The dirt and bacteria are caught by the 
flakes of the chemical, and these flakes are caught and 
held back by the sand. When the flakes of chemical 
begin to clog the filter, the sand has to be washed by 
water which is forced up through it from below. 

Another way of purifying water is by the use of 
chlorine. You have heard of the use of poisonous gases 
in warfare. One such gas is chlorine. Chlorine gas is 


WATER SUPPLY 


35 


poisonous to all living things. Does it seem dangerous 
to add such a substance to a drinking-water supply? 
It is not dangerous, because it is used in such small 
quantities. Not enough is added to be injurious to man, 
but enough is put in to kill bacteria. 



DIAGRAM SHOWING HOW CHLORINE IS PUT INTO 
A WATER SUPPLY 

Chlorine is usually bought in tubes which look much 
like the large tubes you have seen at soda fountains. 
These are attached to a small pipe through which water 
is running, and the gas is allowed to mix with the water 
and be dissolved. This small amount of water contain¬ 
ing the dissolved chlorine gas then flows into the large 
water main, where it mixes with the whole supply, 
reducing the amount of chlorine to the point where it 
does not produce a disagreeable taste or odor, but still is 
present in quantity sufficient to kill the bacteria. 
































36 


COMMUNITY HEALTH 


Keeping watch over the water supply. — Continual 
watch is kept over a city water supply by tests made in 
the Health Department to make sure that the water 
remains pure. In the past, epidemics of typhoid fever 
have been caused by infected water supplies. The story 
of such an epidemic at Plymouth, Pennsylvania, is told 
in the chapter on Waste Disposal. City water supplies 
are now so carefully controlled that there is less typhoid 
fever in cities than in the country. It is easy to keep 
watch over the city water supply and see that no im¬ 
purity gets into it, but in the country every family has 
its own water supply, and these small separate supplies 
cannot be controlled easily by the Health Department. 

Of course, it is just as important for families in the 

country to have pure 
water as for those in the 
city. The primary prob¬ 
lem here is to secure 
pure water in the first 
place. If one is obliged 
to use, for a time, water 
which is suspicious, there 
are simple ways of puri¬ 
fication in the home. 

Well water or spring 
water is safe only if pro¬ 
tected so that no pollu- 
a well which is properly tion fr° m body wastes 
protected can enter it. Could you 















WATER SUPPLY 


37 


answer the following 
questions satisfactorily 
in regard to the water 
supply which you use in 
camp or in your country 
home? (i) Is the well 
or spring located in a 
place where there is no 
possibility of drainage 
from a toilet or stable? 

(2) Is it completely cov¬ 
ered at the top and pro¬ 
tected thoroughly, so 
that no pollution from 
people or animals can 
enter from the surface? 

(3) In case of any possible doubt, have you consulted 
the Health Department of your town, your county, or 
your state? 

Sometimes during camping or traveling one is obliged 
to use water which is suspicious. Remember that 
boiling water makes it safe, because the harmful bacteria 
cannot live through this process. It is worth while to 
take a little trouble to purify water if you do not feel 
certain that it is pure. 

Ice. — Ice should be as pure and safe as water because 
the practice of putting ice into cold drinks is extremely 
common. Much of the ice used in cities nowadays is 
made in electric refrigerators or in factories, being frozen 



DIAGRAM SHOWING HOW THE 
WELL IS PROTECTED 



















COMMUNITY HEALTH 


38 

from the pure water of the city supply. Natural ice is 
usually pure unless there has been pollution on top of 
the ice after it begins to freeze. 

Professor Sedgwick tells in a delightful way the story 
of ice formation: * 

“ There appears to be good ground for the popular 
belief that natural ice considerably purifies itself in 
freezing. The ideal and most favorable condition is that 
offered by a lake of pure, quiet, and deep water in a region 
remote from human habitation. In such a case, on a 
still, cold night, the surface of the lake, chilled by the 
freezing air, hardens into a thin and delicate mirror 
composed at first of shooting, interlacing crystals. Each 
of these, as it forms on the very surface of a mother- 
liquor which is itself almost wholly pure, readily pushes 
aside most foreign substances such as bacteria, though 
between the shafts of neighboring crystals or on their 
surfaces a few may be caught and confined. A little 
later, the first horizontal skimming of ice having been 
formed by the interlocking or other union of crystals, 
fresh crystals send shafts downward into the now more 
quiet water just beneath them, and, the cold continuing, 
join themselves firmly to the layer already formed. 
But now quiet reigns below the ice, and gravity in¬ 
cessantly drags downward through the water everything 
within its reach. The purest layer of water, therefore, is 
now the highest, and into this fresh crops of crystals are 

* Sedgwick, William Thompson: Principles of Sanitary Science and the 
Public Health. 



WATER SUPPLY 


39 


steadily growing from above. Thus it happens that the 
uppermost layer of the ice is least pure, for this includes 
more of the dust of the air, more floating matters, and 
is formed without any overlying sheltering solid layer, 
such as, after its formation, stills the water and shields 
the under layers. This ideal condition, however, is rarely 
found. An impure pond or river is too often the source 
of supply. A sudden freeze often follows a thaw which 
has made turbid and dirty the waters from which the 
ice is then derived; or a snow falling during a dry and 
windy period collects from the air a vast amount of dirt 
and falls upon pure ice, finally thawing and then freez¬ 
ing, only to weld itself as poor and porous ‘ snow ice ’ 
to the better, purer ice beneath it.” 

It should be fairly easy for you to draw your own con¬ 
clusions now in regard to ice. If you know that the 
source of your supply is satisfactory, you may use the 
ice freely, without anxiety as to pollution. If there is a 
possibility of pollution in the ice, you can avoid actually 
putting the ice into your cold drinks and use it merely 
for chilling in the ice box. 

Sanitary drinking cups and bubblers. — All the pre¬ 
caution to protect a water supply at its source may be 
offset by careless habits of drinking in home, school, and 
factory. Undoubtedly there are countless families in 
which common colds and more serious forms of illness 
are spread by use of common drinking glasses. In some 
parts of the country the common drinking cup is still 
used in public places, where it is a source of danger to 


40 


COMMUNITY HEALTH 


all who use it. Bubbler fountains are supposed to remedy 
this evil, but they are not effective unless they meet the 

proper sanitary require¬ 
ments. The stream of 
water should be thrown 
from the side so that it 
does not fall back over 
the opening of the bub¬ 
bler. The latter should' 
be arranged in such a 
way that no person can 
put his mouth on the 
opening. 

Responsibility. — In 

the protection of a water supply, as in other problems of 
community health, there is the twofold responsibility — 
that of the government and that of the individual. The 
local government should ensure a safe water supply for 
the citizens of the town and city. Each citizen should 
refrain from any act which will pollute the water supply, 
and should avoid infection through common drinking 
cups or insanitary bubblers. 

Problems and Projects 

i . What qualities should the water of a public supply possess? 

2. Make a drawing of the cross section of a sand filter. 

3. Make a drawing of a well properly protected from pollution. 

4. Make a drawing of a spring properly protected. 

5. Make an investigation of your city water supply. Where 

does the water come from? How is it purified? 








V 


WHOLESOME FOOD 

In what ways is food related to health? 

What personal responsibilities do we have in securing proper 
food? 

To what extent is diet related to the customs and living condi¬ 
tions of people? 

Are communicable diseases ever spread through food? 

What does our government do for us in securing a wholesome and 
safe food supply? 

The vigor of a nation is largely determined by its 
diet. For the individual or for the community, food is 
one of the first health considerations. Every one who 
goes into training for athletics, or for general health and 
efficiency, finds that proper diet is a most important 
part of his training program. Since you first began to 
follow the rules of health, you have known the impor¬ 
tance of suitable and regular meals. Every person who 
wishes to safeguard his health must exercise some care 
over the kind, the quantity, and the cleanliness of the 
food which he eats. 

Food substances. — Your earlier study of health has 
taught you the kinds of food substances, which include: 
(i) proteins , for growth and repair (found in milk, eggs, 
meat, and fish); (2) sugars , starches , and fats, for energy 
or fuel to make the body go and to keep it warm; 

4T 


42 


COMMUNITY HEALTH 


(3) minerals , to aid growth and regulate the body proc¬ 
esses; (4) vitamins , to regulate the body processes (impor¬ 
tant regulating and mineral foods are fruits, vegetables, 
dark breads, whole-grain cereals, milk, and eggs); and 
(5) water , to regulate body processes. 

A knowledge of the scientific facts about foods shows 
that it is extremely important to eat a variety of the foods 
which nature intended us to have. Indeed, there is 
grave danger in limiting one’s food to a few items only, 
unless those items of food are chosen with special care. 
Food is so important in maintaining health that doctors 
now use diet in treating many kinds of sickness. The 
market is the place where nature’s products are sold, 
and surely it is not too much to say that some of the 
best medicines of the human body can be bought there 
instead of in the drug store. 

Just as there are some especially beneficial substances 
in food, there are also some injurious ones. Certain 
mushrooms and certain inedible species of fish contain 
natural poisons. A few people are sensitive to substances 
in some of the most wholesome foods, such as strawber¬ 
ries, eggs, tomatoes, milk, or oatmeal. These foods 
cause a rash on their skin. The trouble here is not a 
defect in the food but in the person. It is often possible 
for children to overcome this difficulty by eating small 
amounts and gradually increasing the portion. 

Changing food habits. — Have you ever thought of the 
changes in food habits which accompany changes in 
the manner of living? Home Life in Colonial Days , 


WHOLESOME FOOD 


43 


written by Alice Morse Earle in 1898, describes the 
customs and habits of people in colonial times. Their 
food habits furnish quite a contrast to our own. In the 
early days of our country the entire food of a household 
could be produced on the farm. In a paper published in 
The American Museum for 1787, a farmer says: “ At 
this time my farm gave me and my family a good living 
on the produce of it, and left me one year with another 
hundred and fifty dollars, for I never spent more than 
ten dollars a year, which was for salt, nails, and the like. 
Nothing to eat, drink, or wear was bought, as my farm 
provided all.” 

What a contrast to the modern conditions of living! 
What percentage of the things to “ eat, drink, or wear ” 
was bought by your family last year? It is difficult for 
our imaginations to picture the lives of the people who 
lived in the thirteen original colonies. We find in books 
like the one mentioned above such interesting facts as 
those reproduced in the next few paragraphs. 

In Georgia the Indians sold a deer for sixpence, and 
thirty-pound wild turkeys for fourpence each. Wild 
pigeons sold in Boston for a penny a dozen. The seas, 
rivers, and lakes teemed with fish. There were many 
families that found their supply of sweets in maple sugar 
and wild honey. Milk cost a penny a quart. 

In 1728 there was a discussion in the Boston news¬ 
papers as to the expense of keeping a family “of 
middling figure.” The writers all named only bread and 
milk for breakfast and supper. Bread was made of 


44 


COMMUNITY HEALTH 


— 

jllllll Mill /VjjTTgmqfftgga 

in 

4 a 


11 053 " 1 ——r 


tm' » uMmVwIimS 


HOME LIFE IN COLONIAL DAYS 


“ rye-an’-injun,” which meant half rye meal and half 
corn meal. Pumpkins and squashes were native dishes. 
Indian corn, a native of American soil, not only saved 
some of the colonists from starvation but became one of 
the most important foods. 

The Virginia Indians boiled beans, peas, corn, and 
pumpkins together, and the colonists liked the dish. 
Potatoes were known to New Englanders, but they 
were not commonly used. Beans were abundant and 















































WHOLESOME FOOD 


45 


were baked by the Indians in earthen pots, just as we 
bake them today. The settlers planted peas, parsnips, 
turnips, and carrots, which grew and thrived. Huckle¬ 
berries, blackberries, strawberries, and grapes grew 
wild. Apple trees were planted and grew well. Peas 
were plentiful and good in all the northern colonies. 

Pickles, sliced fruit, preserves, candied fruit, and mar¬ 
malades were dainties which were made in most homes. 
In all households, even in those of great wealth and 
many servants, assistance was given in all housewifery 
by the daughters of the household. 

Salted meat was eaten, but very little fresh meat was 
used, for there was no means of keeping it. Perhaps the 
busiest month of the year was November, or “ killing 
time,” as it was called. When the chosen day arrived, 
the oxen, cows, and swine which had been fattened for 
the winter’s stock were slaughtered early in the morn¬ 
ing, so that the meat might be hard and cold before 
being put in the pickle. Sausages and headcheese were 
made; lard was tried out and tallow saved. 

How strange it would seem to have fresh meat only 
occasionally! Apples and cabbage must have been very 
important foods in winter. Think of having “ rye-an’- 
injun ” bread, no sugar, and little or no molasses! The 
diet of our forefathers was different from ours, but was 
it less healthful? What do you think? 

The farmer who wrote in The American Museum in 
1787 certainly had one advantage so far as his food was 
concerned. He knew that it was clean because it was 


46 


COMMUNITY HEALTH 


all raised and prepared on his own farm. He was sure that 
only healthy animals were killed, that all vegetables were 
grown in unpolluted soil, and that the food was clean 
when he got it. He did not have to rely upon other 
people to prepare it for him. Today, living as we do in 
cities, we must depend mostly upon other people. How 
many boys and girls in your class raise their own vege¬ 
tables, fruits, pork, beef, or chicken? 

Few of us raise our own food supply; we even buy a 
great deal of our food already cooked. This is not 
necessarily a disadvantage. In fact, the earth could 
hardly support the number of people living upon it 
today if every family raised all it needed to “eat, drink, or 
wear.” We expect to buy most of our food, but we want 
to be sure that the food is clean, wholesome, and properly 
prepared. We cannot look up for ourselves the source of 
each article in our diet, but our government guarantees 
and safeguards the quality of the most important foods. 

Food adulteration. — One of the things which our 
government does is to prevent the adulteration of food. 
There are various ways in which food may be adul¬ 
terated. Sometimes a valuable part of the food is re¬ 
moved, as when cream is taken from the top of milk and 
the skimmed milk is sold for whole milk. Sometimes a 
poorer substance is sold in place of a better one, as when 
cottonseed oil is sold for olive oil. Frequently some 
foreign substance has been added to a food. For exam¬ 
ple, cocoa and chocolate have been adulterated by the 
addition of starch or sugar; water has been added to 


WHOLESOME FOOD 


47 


milk; and ordinary sugar dissolved in water has been 
added to maple syrup. Cheap candy is sometimes made 
of materials which are not the best. Frequently, as you 
see,’ the adulterated food is not injurious to health, but 
the customer is cheated because the food he buys is not 
what it is represented to be. Sometimes people sell 
food which has spoiled and which endangers health. 

It was found long ago that a large percentage of the 
food sold in the United States was adulterated. This 
knowledge led to the passage of the Food and Drug Act 
in 1906. This act defines the different kinds of adul¬ 
teration and demands that the label on the package shall 
tell the truth concerning the product within. It also 
prohibits the shipping of adulterated foods from one 
state to another. This law does not prevent the manu¬ 
facture and sale of adulterated food within any partic¬ 
ular state, and each state, therefore, has its own food 
adulteration law. 

The Food and Drug Act also prevents the dishonest 
labeling of drugs and patent medicines which are sold 
in packages. The exact amount of alcohol and other 
harmful substances must be stated on the label. The 
label cannot carry untruthful statements concerning the 
cures which the medicine will effect. One should remem¬ 
ber, however, that this law applies only to the truthful¬ 
ness of the label on the package; it does not apply to the 
advertising which is done in newspapers and magazines. 
You may be interested to discuss in class some of these 
advertisements which claim impossible cures. We 


COMMUNITY HEALTH 


48 

must always use our common sense and not put too 
much faith in advertising statements of this kind. 
People are further protected from the “ habit-forming ” 
drugs by the Harrison Narcotic Law, which definitely 
restricts the sale of such substances. 

Meat inspection. — Another service of our govern¬ 
ment in securing clean and wholesome foods is the 
inspection of meat. It is important that meat should 
come from animals which were free from disease. In¬ 
spectors examine the sanitary conditions of the buildings 
in which animals are killed; they examine the animals 
before slaughter; they examine the meat after slaughter; 
and they watch the processes of preparing meat products 
for shipment. Meat from diseased animals, or meat 
products which are unhealthful because of the insanitary 
conditions in which they are prepared, are condemned 
and destroyed. 

Certain meats may also be injurious, unless they are 
thoroughly cooked, because they contain parasites. A 
parasite is a plant or animal which lives upon some other 
plant or animal, called the host, and gets its food from 
the host. Parasites are interesting because they have 
such a strange existence. 

You have no doubt heard of the tapeworm, which 
lives in the intestine of man. It absorbs for its own use 
the food which the body needs, and thereby lowers the 
general health. A common form is the beef tapeworm, 
which gets into the intestine when man eats beef con¬ 
taining the worm in its immature stage. The eggs of 


WHOLESOME FOOD 


49 


the tapeworm are then expelled in the body waste, and 
may reach cattle through their food or drinking water. 
The eggs develop inside the cattle, and the worm in its 
larval stage works its way into the muscles of the ani¬ 
mal. Unless these parasites are killed by thorough 
cooking before the meat is eaten, they develop into 
the adult tapeworm in the intestine of man. 

This train of events by which new generations of the 
animal are produced is called the “ life cycle ” or “ life 
history ” of the parasite. There are also a pork tape¬ 
worm and a fish tapeworm. If the presence of these 
parasites is discovered when the meat is inspected, the 
meat will be condemned, but a further safeguard is to 
have meat thoroughly cooked. 

Another parasite which is sometimes found in pork is 
a round worm called Trichinella. These parasites are 
in the muscle of the infected animal, and when the meat 
is eaten without thorough cooking, the parasite develops 
in the human intestine. There the worms produce their 
young, which get into the blood stream and make their 
way through the body of man into his muscles. This 
process is accompanied by illness with high fever and 
much pain in the muscles. The Bureau of Animal 
Industry has found that this parasite cannot always 
be detected in the examination of hogs, and it has 
issued a warning that pork should always be cooked until 
every part of the meat has turned white. Cooking is a 
great sanitary safeguard, and there is no danger from 
animal parasites when food is thoroughly cooked. 


50 


COMMUNITY HEALTH 


Most animals are healthy, but meat inspection is well 
worth while in preventing the use of meat from an 
occasional diseased animal. The Federal Government 
spends about five million dollars a year in inspecting the 
meat which is shipped in interstate commerce. About 
one-third of the meat used in this country is raised in 
the same state in which it is consumed. Federal food 
inspectors do not inspect such meat supplies, and it is 
therefore important that states and cities should provide 
their own meat inspection service for local products. 

Food Sanitation. — Most bacteria, as you have 
already learned, are harmless. Some are even helpful. 
The flavor of butter and of certain kinds of cheese is 
due to the presence of special kinds of bacteria. Vine¬ 
gar is made by the action of acetic-acid bacteria grow¬ 
ing in apple juice. Buttermilk and various sour-milk 
drinks are the products of lactic-acid bacteria. 

On the other hand, the most important health problem 
arising from the fact that we cannot produce our own 
food is that which is due to the existence of the harm¬ 
ful bacteria. Of course the great sanitary safeguard of 
cooking can be relied upon to kill bacteria, but there 
are some foods which we eat without cooking. It is also 
possible under some conditions that foods may be 
infected with harmful bacteria after they are cooked. 
You have already studied the care of food in the home. 
Let us now consider the sanitation of food from the 
standpoint of the community. 

Milk. — It is not surprising that the sanitation of the 


WHOLESOME FOOD 


5 1 


milk supply should receive first consideration, for milk 
has always been the most important single food of most 
nations. The history of milk production is a fascinating 
story. We are told that, thousands of years ago, on the 
plains of Central Asia, the ancestors of all the “ white 
races” of the present time were herders of cattle. So 
important were the cows to the people of that ancient 
day that the king or warrior chief received the title of 
“Gopatis,” meaning “Lord of the Cows.” The posses¬ 
sion of cattle meant happiness and prosperity; he who 
was king of the people must be able to provide for the 
protection and well-being of the herd. No subject of 
the Gopatis could kill a cow even for food, for the people 
knew that the cow’s milk was of greater importance than 
meat. The records of these people say that “the killer 
of a cow must stay a month in penitence, sleeping in a 
stable, following the cows, and he must purify himself by 
the gift of another cow.” 

If we had time we could trace through the history of 
many nations the story of the dairy industry. When the 
Hebrews came into their ideal Promised Land, they 
described it, not as a land rich in gold or jewels, but as a 
“land flowing with milk and honey.” You may know 
that goat’s milk as well as cow’s milk has always been 
used. 

Cattle did not exist in America before the white 
people came from Europe. When the Pilgrims first 
set foot on Plymouth Rock they brought no cows 
with them. Later, cows and goats were brought from 


52 


COMMUNITY HEALTH 


Holland — enough to supply one cow and two goats to 
every six people. 

The pioneers profited from the experience of these 
early settlers. When they took their families and pos¬ 
sessions into the Middle West they carried their cows 
with them. Today the great dairy industry reaches 
from the Atlantic to the Pacific, producing millions of 
quarts of milk each day by such careful methods that 
milk is brought to you clean and safe. Let us see what 
things are to be considered in the care of the milk sup¬ 
ply nowadays, when cities are so large that some of the 
milk must be brought three or four hundred miles. 

In your study of the care of foods last year you learned 
how easily milk spoils. Bacteria grow rapidly in it un¬ 
less it is kept cold, and there are always some bacteria 
present. The most common ones are the lactic-acid 
bacteria, which feed upon milk sugar and sour the milk. 
If the bacteria which feed upon the protein are more 
numerous, the milk putrefies; it becomes bitter and 
unfit for use. If disease germs get into the milk from a 
tuberculous cow, or from a milk handler who has tuber¬ 
culosis, typhoid fever, diphtheria, scarlet fever, or 
septic sore throat, the milk is really dangerous to use 
until it has been cooked or heated in the process of 
pasteurization. 

The work of the government in controlling the milk 
supply begins at the dairy. It is of first importance to 
see that the cows are free from the form of tuberculosis 
to which they are subject. This is called bovine tuber- 


WHOLESOME EOOD 


53 

culosis (from the Latin bos , meaning “ cow ”). The 
germ of the disease is slightly different from that of 
human tuberculosis, but the bacillus of bovine tuber¬ 
culosis can cause the disease in man. A simple test (the 
tuberculin test) is used on the cows once a year or oftener 
to find out whether they have the disease. 

There are definite sanitary regulations which govern 
the dairies. Every well-regulated dairy maintains these 
sanitary conditions. The barns are well constructed and 
have smooth floors. They are kept clean and free from 
dust and odors. There are plenty of windows, so that 
the barn is flooded with sunshine and fresh air. The 
buildings are located on high land, so that they are well 
drained. The manure is removed every day and is 
disposed of in a way to prevent the breeding of flies. 

There is a special room or house for taking care of the 
milk. It is spotlessly clean and screened to keep out 
flies. There is hot water for cleaning the utensils and 
steam for sterilizing them. If the dairy is not supplied 
with steam the utensils should be thoroughly scalded 
after washing. When not in use they are kept free from 
dust or other dirt. 

The milker is a man of good health, free from any 
disease with which he might infect the milk. He wears 
a clean white suit for milking, and washes his hands with 
soap and warm water before milking each cow. He uses 
a pail with the top partly covered, in order to keep out 
the dust. His cows are kept clean, with their hind quar¬ 
ters and tails closely clipped. Their udders are washed 


54 


COMMUNITY HEALTH 



MILKING IN A HIGH-CLASS DAIRY 

before milking. These last-mentioned precautions are 
well executed only in the best dairies. 

After the milking the milk is immediately cooled so 
that bacteria cannot grow rapidly, and it is kept under 
refrigeration constantly until it reaches the place where 
it is to be used. 

Even with the inspection of dairies, cities very wisely 
insist upon the pasteurization of milk. This means 
heating to a temperature of from 140° to i45°F. for 
twenty to thirty minutes, or to a higher temperature for 
a shorter period. Pasteurization improves the keeping 
quality of the milk and kills any harmful bacteria which 
are in it. 

Only milk of the highest quality is safe without being 




WHOLESOME FOOD 


55 

pasteurized. Such milk (“certified milk/’ “grade A raw 
milk/’ or “special babies’ milk”) is produced under 
the supervision of a group of physicians called the Med¬ 
ical Milk Commission. The cows, the milkers, and the 
milk handlers are examined every day to be sure that 
they are perfectly well. The milk is drawn and handled 
so carefully that it contains very few bacteria, and it is 
delivered within twenty-four hours after it is milked. 

It would be impossible to produce enough milk near 
the large cities to give us the amount we need. We 
are therefore obliged to secure a great deal of our milk 
supply from farms far removed. It is also difficult to 



A PASTEURIZING MACHINE 






COMMUNITY HEALTH 


56 

have milk produced under ideal conditions. For these 
reasons pasteurization has come into general use. 

The pasteurizing process makes it possible to furnish 
milk in large quantities to people in the city at a mod¬ 
erate price. The ideal method is to pasteurize the milk 
in the bottle. Sometimes, however, it is pasteurized in 
bulk and bottled later. If the bottling is done promptly 
and the methods are clean, this system is satisfactory. 

In order to keep the milk supply safe and clean, the 
town or city government licenses the people who sell 
milk. Samples of the milk are taken regularly and 
analyzed in the Health Department laboratory. Regular 
inspections are made of dairies, milk wagons, and all 
places where milk is sold, to make sure that sanitary 
regulations are obeyed. 

Other foods . — There are other foods besides milk 
which need sanitary control. We have already spoken 
of the control of the meat supply. Shellfish are some¬ 
times eaten without being cooked, and therein lies a 
danger. If they are taken from water into which sew¬ 
age flows, they may pick up the germs of typhoid fever 
from the polluted water and so transmit the disease. 
Cities and states have therefore found it necessary to 
make regulations in order to be sure that oysters are 
taken from unpolluted waters. Some vegetables are 
eaten raw; even though they are thoroughly washed in 
the home it is important to be sure that they were not 
grown on land which was polluted with human body 
waste, and that they were kept clean in the market. 


WHOLESOME FOOD 


57 


Food poisoning. — Doubtless you have heard of 
instances of food poisoning (the term “ ptomaine poi¬ 
soning ” should not be used) where several people have 
suffered ill effects from eating some particular food. 
These food poisonings are of two types. One kind of 
food poisoning is called botulism, and is caused by a 
bacillus which sometimes gets into food that is not 
kept clean. This sort of poisoning has been known to 
occur from sausage, pork, and vegetables. The bacillus 
of botulism grows upon the food before it is eaten and 
produces a poison. 

The other kind of food poisoning, which is still some¬ 
times miscalled “ ptomaine ” poisoning, is really an 
infection of the person with some bacillus which has 
reached the food (meat, milk products, or vegetables) 
because it was not kept under sanitary conditions. These 
bacteria grow in the human intestine and cause an 
irritation. We see, then, that food poisoning arises from 
failure to keep food scientifically clean. 

Food control. — If food is handled by any person 
who has a communicable disease, it is possible, of course, 
for the person to transfer disease germs to the food. In 
this way the disease may be transferred to another 
person. Common cold is undoubtedly spread in this 
way, not only in restaurants, but in the home from one 
member of a family to another. You think perhaps 
that this process of transferring disease germs through 
food cannot be very dangerous because most sick people 
are in bed and not handling food for others. People do 


COMMUNITY HEALTH 


58 

not go to bed with common colds, although it would be 
better if they did. Sometimes a person has a disease in 
such a mild form that it is not recognized, and after he 
appears to be entirely well he still carries the germs in 
his body for a while. A person who carries the germs of 
a communicable disease without being sick himself is 
called a disease carrier. The diseases with which foods are 
most likely to become infected are common cold, typhoid 
fever, tuberculosis, and dysentery. 

What has been said about food poisoning and the 
transfer of disease by people who handle food shows 
clearly what the community government needs to do in 
order to protect the people. It is necessary to supervise 
markets, bakeries, food shops, and restaurants to see 
that the places are sanitary, that the food is properly 
handled, and that it is not exposed to flies or dirt. People 
who handle food in bakeries and eating places should 
be examined regularly by a doctor to make sure that 
they are in good health and will not transmit any disease 
through the food. 

It is impossible to list here all the details of food-shop 
sanitation. One important point is to have the whole 
place well screened so that the shop is free from flies. It 
is necessary that food handlers should wash their hands 
frequently. For this reason every food shop should 
provide convenient and sanitary facilities for hand¬ 
washing. Another item of importance is to have the 
food covered, and not displayed on top of show cases 
where customers stand over it or handle it. 


WHOLESOME FOOD 


59 



THE DOCTOR EXAMINES A FOOD HANDLER 


Ice cream production is supervised, too, because bac¬ 
teria can live in ice cream, and it has been known to be 
the means of transferring disease. It must be made of 
pure milk or cream and produced under sanitary con¬ 
ditions. 

Cold storage and refrigeration of food also receive 
government supervision. The use of refrigeration makes 
it possible to transport foods from one part of the country 
to another without spoiling. Cold storage makes it 
possible to preserve foods for a long time. The govern¬ 
ment protects us by requiring that foods shall be stored 
under sanitary conditions and at proper temperatures. 
They are sold as cold storage goodSi 

You have learned in this chapter some of the things 
which are done by the city government, and probably 








6 o 


COMMUNITY HEALTH 


you appreciate more than ever before the importance 
of having a good Health Department. Do not think, 
however, that these dangers which are pointed out are 
common. Food dangers are relatively rare, and those 
which do exist are usually found by the Health Depart¬ 
ment, so that we are carefully protected. The fact that 
there are a few patches of poison ivy in the field or in 
the woods does not worry the farmer. Knowing what 
they are and where they are, he takes care not to get 
into the ivy and get poisoned. Likewise, our govern¬ 
ment knows what are the dangers in the food supply 
and protects us from them. 

Problems and Projects 

i . What are the different kinds of food substances? 

2. What do they do for the body? 

3. Why is it important to get the right amount of food? 

4. Contrast our present diet with the diet of the early colonists. 

5. Contrast the methods of securing food today with those of 

the early colonists. 

6. What are the different kinds of food adulteration? 

7. What should be done to keep cooked food clean in stores? 

At home? 

8. Look in the stores where you buy vegetables, fruit, or cooked 

food and find out what care is taken to keep the food clean. 

9. Give reasons for the importance of milk as a food. 

10. Give rules for keeping milk after it is delivered. 

11. Visit a dairy and write a report on the sanitary conditions. 

12. Lantern slides and strips of film are available on the subjects 

of clean milk and food control. Write to your State De¬ 
partment of Health for information. 


VI 


ALCOHOL, TOBACCO, AND OTHER HARMFUL 
SUBSTANCES 


What is a narcotic? 

Does the use of tobacco actually affect athletic ability? 

Does it affect scholarship? 

Why is a locomotive engineer forbidden to use alcohol? 

What are the effects of alcohol upon the body? 

Why is the use of alcohol a community problem? 

The problem. — One part of the alcohol, tobacco, and 
drug problem is the relation of these substances to 
personal health and efficiency. People who are enthu¬ 
siastic in their support of personal freedom feel that one 
should have a right to smoke or drink, no matter how 
much it may injure him. Many feel, however, that 
their lives are so closely tied up with the lives of others 
that they can scarcely assert “ personal rights ” in this 
selfish fashion. We are valuable members of a social 
group, or effective citizens in a community, only when 
our lives are regulated in a way which is reasonable and 
which enables us to maintain health and efficiency. If 
we, through self-indulgence, reduce our health and 
efficiency to the point where we do not contribute 
anything to other people through our thought or our 
work, we are of little importance so far as the community 

61 


62 


COMMUNITY HEALTH 


is concerned. If we go a step farther, reducing our 
health and efficiency to the point where we become 
objects of care to other people, we are actually a burden 
to the community. Do you not think that society, as 
well as the individual, has rights and that we should 
consider the rights of others as well as our own? 

Another part of the problem is that which arises from 
the social difficulties which accompany the excessive 
use of alcohol and drugs. A man who drinks habitually 
and heavily frequently fails to provide a living for his 
family. He cannot hold a job because he is not reliable, 
and what money he does earn is drawn upon heavily for 
liquor. Who can say how far-reaching are the effects 
of such a situation upon the lives of children? Who 
supports such families? 

Still another phase of the problem is the danger to 
human life which comes about through the excessive 
use of alcohol and drugs. What do you know of the 
relation of drinking to automobile accidents? Have 
you ever heard or read of a fatal accident caused 
by an automobile driver or some other person who 
was drunk? 

This chapter deals with the use of alcohol, tobacco, 
and drugs chiefly from the standpoint of their relation to 
health and efficiency and their cost to the community. 
The social effects of the excessive use of alcohol and 
drugs are extremely important, however, and they 
should not be lost sight of when we are considering 
the undesirable results of the use .of alcoholic liquors. 


HARMFUL SUBSTANCES 


63 


TOBACCO 

Probably most of you know that tobacco is a plant. 
In the same family with it are the potato, the tomato, 
and the poisonous henbane and deadly nightshade. 
The harmful substance in tobacco is nicotine, which is 
a narcotic. Narcotics, in effect, “ put part of the brain 
to sleep.” When they are powerful enough and used 
in large enough doses, they produce unconsciousness. 
The effect of nicotine in small quantities is less extreme 
than the effect of many other narcotics, as, for example, 
alcohol and opium, but its effect is distinctly poisonous. 

Effects of smoking. — There is a common belief that 
smoking interferes with athletic ability. A very inter¬ 
esting study of smokers and nonsmokers has been made 
by Professor J. Rosslyn Earp.* 

In ordinary college athletics it is difficult to learn 
anything about the effects of smoking. In intercol¬ 
legiate sports so much emphasis is placed upon winning 
that the men are all put in training for some time before 
the event, so that even those who ordinarily would 
smoke do not use tobacco at all for some time before 
they compete. At Antioch College a different situation 
is found. There the sports are looked upon only as 
recreation, so that training rules are not enforced. 

Professor Earp made a study of two track meets, one 
held in 1924 and the other in 1925. The first meet was 
competition within the college, and the second was a 

* Earp, J. R.: The Student Who Smokes. Antioch Press, 1926. 


64 


COMMUNITY HEALTH 


friendly competition with another local college. Pro¬ 
fessor Earp believes that there was enough interest in 
the meets to attract the best athletes in college, although 
probably none of them were enthusiastic enough to 
change seriously their habits of living prior to the time 
of competition. 

There were about as many smokers as nonsmokers in 
college. It would be fair to expect that the winners in 
these track events, then, would be about evenly divided 
between the group of men who smoked and those who 
did not, unless the use of tobacco actually interferes 
with athletic success. The exact results of these two 
track meets are shown in the following tables, which 
are taken from The Student Who Smokes. 

I. Winners of Events in Intramural Track Meet 


at Antioch College, May, 1924 


Event 

First Place 

Second Place 

Third Place 

100 yards dash. 

. H 

N 

— 

Shot put. 

. . M 

N 

(H)? 

220 yards dash. 

.. N 

N 

— 

Pole vault. 

.. N 

N 

— 

Javelin throw. 

.. N 

L 

— 

Half-mile run. 

.. N 

N 

N 

440 yards run. 

.. N 

— 

— 

High jump. 

L 

N 

N 

Mile run. 

.. N 

N 

N 

Broad jump. 

L 

N 

N 

Discus throw. 

N 

(N)? 

N 

Relay team. 

. . N 

N 

L 

N = Nonsmokers 

L = Light smokers 



M = Moderate smokers H = Heavy smokers 














HARMFUL SUBSTANCES 65 


II. Winners of Events in Intercollegiate Track Meet 


Event 

at Antioch College, May, 1925 

First Place Second Place 

Third Place 

100 yards dash 

. N 

N(v) 

N 

Shot put. 

. H 

H(v) 

N(v) 

220 yards dash 

. H(v) 

N 

H(v) 

Pole vault.... 

. N 

N 

N 

Javelin throw. 

. N 

H 

N(v) 

Half-mile run.. 

. N 

N 

N(v) 

440 yards run. 

. H(v) 

H(v) 

N 

High jump... . 

. N 

N 

N(v) 

Mile run. 

. N 

N 

N(v) 

Broad jump.. . 

. N 

N 

M 

Discus throw. 

. H(v) 

H 

N(v) 


(v) indicates member of the visiting team 
N = Nonsmokers L = Light smokers 

M = Moderate smokers H = Heavy smokers 


Certain conclusions may reasonably be drawn from 
this study. Apparently some men have such good 
athletic ability that they can win events even though 
they smoke regularly. On the other hand, it seems 
that when there is competition among a large group of 
men it is likely that more of the winners will be found to 
be nonsmokers than smokers. 

Sometimes the argument is raised that good athletes 
refrain from smoking because they fear that smoking 
will injure their ability, and hence we naturally find 
that most athletes are nonsmokers anyhow. Professor 
Earp questioned Antioch students in regard to this. 
He asked: (i) Why do you smoke (or abstain from 
smoking)? and (2) Have you a school letter and have 













66 


COMMUNITY HEALTH 


you a college letter? Only 2 of the 176 nonsmokers 
said that they refrained from smoking because of its 
possible effects on athletics. 

The comparison of the men who had won their letter 
in school and in college was very interesting. Out of 
177 smokers, 74 gained their letters at high school or 
preparatory school, but only 21 of these won their col¬ 
lege letter. Out of 176 nonsmokers, only 56 gained 
letters in high school, but there were 21 of them who 
won college letters. 

Professor Earp draws the conclusion that the boy in 
school who succeeds as an athlete joins a rather “ heroic ” 
group where he is tempted to smoke, perhaps, more 
than other boys in the school. If he does yield to the 
temptation to take up smoking, his career as an athlete 
is less likely to be successful. This theory is still further 
supported by the fact that, out of 60 Antioch student^ 
who began to smoke during high school days, 37 have 
school letters, while only 3 gained college letters. 

The effect of smoking upon scholarship was also 
studied at Antioch. Smokers were found to vary much 
more in scholarship than nonsmokers. Both groups 
have men among the honor students, but the lower 
scholarship places are entirely filled by the smokers, so 
that on the whole the nonsmokers have a higher average 
of accomplishment than the men who smoke. 

These studies by Professor Earp are very interesting 
because they were made carefully, in a fair and scientific 
way. They seem to indicate that nonsmokers are better 


HARMFUL SUBSTANCES 67 

athletes than smokers, and that smoking hinders scholar¬ 
ship. 

There is certainly no evidence that smoking improves 
health, and there is general agreement among doctors 
that excessive smoking is injurious. Just how much 
smoking is necessary to produce injury, or just what is 
the effect of smoking in a moderate amount, is hard to 
say. Studies upon lung capacity and heart efficiency 
do not show much difference between smokers and 
nonsmokers. We do not know whether smoking inter¬ 
feres with the efficiency of the body or lessens ambi¬ 
tion in some way. If it should be found that smoking 
makes one less interested in securing success in athletics 
and scholarship, the charge against tobacco would be 
more serious than it would be if it merely produces a 
slight physical injury. 

There is some difference of opinion on the subject of 
smoking for adults. There is, however, no disagreement 
as to the injury from smoking for boys who have not 
attained their growth. Doctors and educators are 
unanimous in their belief that the growing boy hinders 
his desired development by the use of tobacco. Smoking 
appears to affect the appetite of the growing boy. He 
does not get the necessary amount of food. Possibly 
another harmful effect is a tendency to make the boy 
nervous, so that he fails to get enough sleep and rest. 
Whatever the scientific reasons may be, it is, certain 
from observation of boys everywhere that those who 
smoke in their early teens fail to develop w r ell in body 


68 


COMMUNITY HEALTH 


and mind. It is also common experience that when they 
break the habit they improve. 

Cost. — Surely another practical argument against 
smoking is the cost. The amount of money spent for 
tobacco in this country has increased by leaps and 
bounds, until we find that more money is spent for 
tobacco than for all educational purposes. From the 
standpoint of the individual, it seems a pity that a 
young man should spend money constantly for tobacco 
at a time when he needs all his money to secure a good 
start in life. From the viewpoint of the community, it 
is unfortunate that such large sums should be spent 
for something which impairs efficiency. 

ALCOHOL 

It is said that the early colonists brought with them 
to this country the drinking customs of their mother- 
countries of the sixteenth and seventeenth centuries. 
Drunkenness was an especially serious matter, however, 
in a new country where everybody must work, where 
dangers from the Indians, were ever present, and where 
men must be ready for instant action. The colonists, 
therefore, began to make laws .punishing drunkenness. 
From that time the fight against alcohol has grown, 
until finally the Eighteenth Amendment to the Con¬ 
stitution of the United States went into effect. It 
prohibits the manufacture and sale of alcoholic liquors 
throughout the country. 

Let us consider some of the facts about alcohol which 


HARMFUL SUBSTANCES 


69 



THE ATHLETE AVOIDS HARMFUL SUBSTANCES 

(Reproduced by permission of the sculptor, R. Tait McKenzie, and the photographer, 
The Black and White Studio, of Philadelphia) 


cause it to be regarded as such an enemy of mankind. 
Most of you know that alcohol is one of the waste prod¬ 
ucts thrown off from yeast plants when they grow in a 
sugar solution. The light wines and beer are made by 
allowing yeast cells to grow in grape juice or barley 






70 


COMMUNITY HEALTH 


liquor. The stronger liquors are made by a process of 
distillation. 

Effects of alcohol. — Alcohol, like nicotine, is a nar¬ 
cotic. Its effect upon the body is to slow down the 
Heartbeat, the respiration, and the activity of the 
nervous system. Many people make the mistake of 
thinking alcohol a stimulant. Under the influence of 
alcohol, people are likely to think that they are brighter 
or more clever, when, as a matter of fact, the contrary 
is true. It is said that a young mountain-climber, after 
taking a drink, boasted that “ he could jump like a 
bird.” “ No,” replied an experienced mountaineer, 
“ you mean like a fool.” 

It is an accepted fact that alcohol hinders athletic 
success. Men in training for any kind of sport are not 
allowed to use it at alh One of America’s foremost 
baseball managers is quoted as saying that “ Old Man 
Booze has put more men; out of the game than all the 
umpires together. ”% , t 

The Carnegie Institution of Washington has issued an 
interesting report on “ Alcohol and Human Efficiency,” 
by Dr. Walter R. Miles. Dr. Miles used a clever appa¬ 
ratus, called the “ pursuit-pendulum,” to test the effects 
of alcohol upon a person’s ability to respond quickly. 
This has also been used to test men for aviation service. 
A pendulum carries a reservoir filled with water which 
is allowed to flow out from the bottom as the pendulum 
swings. The test is to catch the water in a series of 
cups as it escapes from the moving pendulum. Constant 


HARMFUL SUBSTANCES 


71 


attention and alertness are necessary to meet this test. 
Seven out of eight men tested did less accurate work 
after taking only small amounts of alcohol. Dr. defiles 
says that if the task were a factory process the effect of 
the alcohol would be sufficient to reduce markedly the 
men’s efficiency. 

The effect of alcohol upon alertness and quickness has 
also been tested with animals. In one experiment white 
rats were treated with alcohol fumes daily for twenty- 
eight days. Then they were trained to run through a 
circular maze, and were treated with alcohol daily, as 
before. They took more time per trial in running 
through the maze than did their brothers and sisters 
who had not been treated with alcohol. 

Because of the lack of control which is associated with 
the use of alcoholic liquors, drinking leads to an increase 
of accidents. It is interesting to know that the organiza¬ 
tion of the railroad engineers in the United States, 
known as the Brotherhood of Locomotive Engineers, 
has a strict rule requiring total abstinence at all times 
on the part of the members. The president of the 
organization is quoted as saying: 

“When you realize that on these fast trains the en¬ 
gineer must recognize and correctly interpret three 
signals a minute on an average . . . you can under¬ 
stand why every sense must be alert. We who have 
spent most of our lives on locomotives know the . . . 
fraction of a second of time that often means safety. 
Alcohol slows down the brain. Any member of the 


72 


COMMUNITY HEALTH 



ENGINEERS DO NOT DRINK ALCOHOLIC LIQUORS 

Brotherhood found guilty of violating the rule which 
forbids the use of alcoholic liquors either while on duty 
or while off duty must be expelled, and any lodge of 
the Brotherhood failing to enforce this law must have 
its charter suspended by the head of the National 
Brotherhood. ,, 

For a long time physicians have been impressed with 
the fact that alcohol is a factor in shortening life. In 
one general investigation of the impressions of doctors 
as to the importance of alcohol in causing death, it 
was found that alcohol was believed to have played 
a part in about 14 per cent of 10,000 deaths which 
were classified. A scientist who has spent years in 











HARMFUL SUBSTANCES 


73 


the study of the effect of alcohol upon the length of 
life says that heavy drinking certainly shortens life. 

There are probably many reasons why this is true. 
It has been found by scientific study that excessive use 
of alcohol weakens the defense of the body against 
disease germs. Undoubtedly people who lack self- 
control in the use of alcohol are commonly unreasonable 
in their other habits of living too, and thus injure their 
health. Men who are heavy drinkers are looked upon as 
poor “ risks ” by the life-insurance companies. 

Since the Prohibition Law was passed, some people 
who do not want the law insist upon getting liquor in 
unlawful ways. Out of this a new danger has arisen. 
Drinks are manufactured from wood alcohol and other 
poisonous substances, which affect the body even more 
seriously than does pure alcohol. There have been 
cases of blindness from the use of such liquors, and, 
indeed, a large number of deaths. 

Alcohol and society. — We have considered the effects 
of alcohol only from the standpoint of injury to the 
individual. There is much to be said in regard to the 
community problem. It appears that men do less work 
when they use alcohol; this means loss of production for 
the community. Certainly alcohol increases the acci¬ 
dent rate, which means loss of life and destruction of 
property. Heavy drinking unquestionably shortens 
the length of life, which again means less production. 
Alcoholics fail in their responsibility as good citizens. 
Many of them become burdens upon public money. 


74 


COMMUNITY HEALTH 


Another problem is that of caring for the alcoholic 
insane. During a five-year period, in Massachusetts, 
the admissions to the State Hospitals were as follows: 


Number of persons admitted 
for alcoholic insanity 

215 

222 

2 37 

176 

188 


Per cent of alcoholics in the total 
number of persons admitted 
6.41 
7-83 
8.08 

5-94 

6.49 


Is it not a pity that tax money should be spent in caring 
for people who have brought themselves to a helpless 
condition through the use of alcoholic liquor? 

Another problem is that of dealing with criminals. 
Because of the effect of alcohol upon the brain, men do 
things after they have been drinking heavily which 
they would not do otherwise. How commonly we read 
in the daily papers of crimes committed by persons under 
the influence of liquor! These men have to be tried in 
court, and they have to be cared for in the jails and 
penitentiaries. Do you have any idea what it costs 
your state each year to take care of criminals? Not all 
criminals are alcoholics, by any means, and undoubtedly 
some criminals who are alcoholics would have committed 
crimes even without liquor. We do feel certain, however, 
that the use of alcohol is an important factor in increas¬ 
ing crime. 

The community has to spend money also in caring for 


HARMFUL SUBSTANCES 


75 


families which are neglected by drunken parents. Some 
of these are the families of the alcoholic insane and the 
criminals. Others are those families which find them¬ 
selves in extreme poverty because of neglect. 


DRUGS 

There are many narcotic drugs which are perhaps 
even more dangerous than alcohol, because of their 
powerful “ habit-forming ” effects. Once a person has 
developed the drug habit, it is almost impossible to break 
it. He is so miserable without the drug that he will go 
to any extreme in order to get more. As a result, there 
is loss of self-control and self-respect, as well as loss of 
health. Among these harmful drugs are opium, mor¬ 
phine, cocaine, heroin, and chloral. 

Some people have formed the drug habit by taking the 
drugs first in patent medicines. In fact, the danger from 
patent medicines was so great that the sale of these 
products is now controlled by national laws. The Pure 
Food and Drug Act requires that all patent medicines 
shall be honestly labeled. The Harrison Narcotic Law 
restricts in a definite way the sale and use of the habit¬ 
forming drugs. 

Patent medicines which are advertised to cure every¬ 
thing or to accomplish a variety of unreasonable results 
are poor investments. You need to remember in reading 
an advertisement that the producer is anxious to sell his 
product and make money. He is interested in you 


COMMUNITY HEALTH 


76 

chiefly as a possible customer. There are, of course, 
a few simple remedies which can be used in the home 
for slight ailments. When a person is ill enough to 
need “ medicine/’ however, the sensible thing to do is 
to call a physician. 

Some of the dangerous drugs are useful in the hands of 
skilled physicians to reduce pain for those who are ill 
and suffering. They cannot be purchased without a 
doctor’s prescription. 

Habit-forming drugs also increase the amount of 
insanity and crime. Is it not a pity that human beings 
should develop these tastes which, at the end, lead to 
misery both for themselves and for others? 

Problems and Projects 

1. What advantages should a country receive from prohibition? 

2. Make a list of all the harmful effects of alcohol. 

3. Make a list of reasons why a boy ought not to smoke during 

his growing years. 

4? What things should you like to have done in your community 
for the promotion of health if you could spend the money 
which is spent every year for tobacco? 

5. Answer the questions at the beginning of the chapter. 


VII 


WASTE DISPOSAL 

What are the household wastes? 

How are rubbish and ashes disposed of in the country? In the 
city? 

What can be done with food wastes from the kitchen? 

How does the disposal of wastes in cities differ from that in the 
country? 

What discoveries have introduced new methods of sewage dis¬ 
posal in cities? 

Rubbish, ashes, and kitchen waste. — The hunter or 
the camper, on the great plains or in the forest, has little 
difficulty in disposing of camp wastes in a sanitary way. 
The ashes of his camp fires are left where they are, and 
if he has a few pieces of food left they are either thrown 
into the fire or buried. The disposal of such wastes on 
the farm is equally simple. Ashes from the stove can be 
dumped at any convenient place away from the house. 
Sometimes a farmer scatters the wood ashes over his 
fields to enrich the land. Sometimes wood ashes are 
stored to be used later for the purpose of extracting lye 
for soap making. Most of the soap used by the pioneers 
was homemade soft soap. Broken dishes and other 
rubbish are dumped in the woods where they will bother 
no one. The scraps of kitchen waste are fed to pigs or 
chickens. 


77 


78 


COMMUNITY HEALTH 


In the city, however, the problems are more difficult. 
The ashes which accumulate soon fill the ash cans in the 
basement. City teams come regularly to collect the 
ashes and haul them away to fill low land. Rubbish is 
collected and taken to the dump. In some cities both 
rubbish and ashes are burned in big furnaces called 
incinerators. 

The kitchen waste must be collected every two or 
three days. It may be carried outside the city and fed 
to pigs, or it may be treated by what is called a reduction 
process , in which the garbage is cooked in large tanks 
so that the grease can be removed and sold. What is 
left after the grease is removed is put with other materials 
to make commercial fertilizer which is sold to farmers to 
enrich the land. In a few cities the garbage is burned 
with the rubbish. 

Sewage disposal. — If you live in a city, you probably 
know that the drains from the house run into the street 
sewer, which carries the drainage off to some distant 
point. This pipe carries all the waste water from the 
house — from the sink, ice box, bathtub, lavatory, and 
toilet. The waste water from factories is carried off in 
a similar way. In some cities rain water from the 
street goes into the same pipe. In other cities there is 
a separate set of pipes to carry off the street water. 

The waste which is carried off through these pipes is 
called sewage , and the pipes themselves make up the 
sewerage system of the city. Even when one realizes 
how much water comes into these pipes from houses and 


WASTE DISPOSAL 


79 



DIAGRAM SHOWING HOUSE SEWER AND PLUMBING 


factories, it is a little surprising to know that the sewage 
in a city amounts to nearly one hundred gallons per day 
for every person in the city. What is the population of 
your town or city? From it you can determine how many 
gallons of sewage must be disposed of daily through the 
sewerage system. 

Direct disposal of sewage. — One of the easiest ways 
to dispose of sewage is to let it flow into a large river or 
lake, or into the ocean. When a city is located on some 
large body of water this is usually the method of dis¬ 
posal. The sewer pipe extends into deep water. Cities 
which are located on the ocean sometimes hold the sewage 
in large tanks until the tide is going out, and then 







































8o 


COMMUNITY HEALTH 


discharge it into the ocean so that it will be carried 
out to sea. The useful bacteria in the water purify 
the sewage, changing it into harmless material. 

Sometimes a city cannot discharge its sewage into a 
river or lake conveniently because of the danger of 
polluting the water supply. Chicago disliked to dis¬ 
charge its sewage into Lake Michigan because lake water 
is used for drinking purposes. Consequently a drainage 
canal has been dug from Chicago to a stream which 
flows into the Mississippi River. The sewage is carried 
away from the city through this canal. Sometimes a 
city which is located on a river cannot discharge sewage 
into the river because some other city, not many miles 
away, uses the river as its water supply. In such a case 
it is necessary to purify the sewage. 

In the simplest methods of sewage disposal nature 
turns the materials back into soil. Every one knows 
that it takes rich soil to make good gardens. Almost 
every soil that produces crops may be made richer by 
adding something to serve as fertilizer. 

What kinds of fertilizer do you know about? If you 
have planted a school garden, you probably bought 
specially prepared commercial fertilizer in a bag at the 
store. If you live in the country, you know of the use of 
animal manure which is hauled out from the barns and 
spread on the fields for fertilizer. In 1621 the Indian, 
Squanto, taught the Pilgrims at Plymouth to put a fish 
into each hill of corn when they did the planting. The 
fish was used as fertilizer. 


WASTE DISPOSAL 


From your work in gardens, and from your study of 
Cleanliness and Health you have learned the nature of 
rich, dark, soft, moist soil, and you have seen how it 
differs from clay or gravel. Do you remember how 
humus soil is made? 

If apples are allowed to stay on the ground and rot 
they gradually turn back into soil. The fish which 
Squanto dropped into the hills of corn rotted and 
enriched the soil. The parts of all plants or animals 
are eventually changed back into soil by the action of 
useful bacteria. Leaves falling to the ground form layers 
which become deeper year after year. When you dig 
down into the leaves in the forest you find that the 
layers which are six or eight inches from the top have 
turned into dark, rich soil. This principle has been 
used in the disposal of sewage. 

Sewage farms. — In Paris, and in some other cities, 
a process of sewage farming has been developed. The 
sewage flows out upon dry land. It enriches the soil 
and is purified as the water soaks into the ground. Of 
course the water does not soak into the soil very rapidly. 
Consequently a great amount of land must be used for 
this purpose. The process of sewage farming has been 
a useful one, however. It may be used wherever the 
soil is sandy, because the bacteria in the sewage and on 
the sand will turn the waste substances back into soil. 

Intermittent sand filter. — As cities grew and land 
became scarce the problem of purifying sewage became 
more and more difficult. Sanitarians sought a method 


82 


COMMUNITY HEALTH 


of purifying sewage more rapidly. In 1887 the state of 
Massachusetts, through its State Board of Health, 
decided to study this problem, and a special experi¬ 
ment station was established at Lawrence. 



THE HISTORIC LAWRENCE EXPERIMENT STATION 
(Reproduced from State Sanitation, by G. C. Whipple, by courtesy of the 
Harvard University Press) 


The station was housed in a small wooden building 
located near one of the big sewers. The studies were 
made under the direction of Hiram F. Mills, C. E., a 
well-known water-power engineer of the State Board of 
Health. Professor Thomas M. Drown of the Massa¬ 
chusetts Institute of Technology was Consulting Chem¬ 
ist, and Professor William Thompson Sedgwick of the 
same school was Consulting Biologist. 





WASTE DISPOSAL 


83 

People had known for a long time, of course, that 
soil would purify body wastes, but they did not know 
how. It seemed worth while to run sewage through 
different kinds of soil to see what would happen. Sev¬ 
eral large tanks made of cypress wood were built in the 
ground and filled with sand. Sewage from the city pipes 
was run into these tanks and allowed to soak through. 

Professor Sedgwick, in his delightful manner, tells of 
the experiment, as follows:* “ No experiments of this 
kind had ever before been undertaken on such a scale 
or with so much care. For the first time in the history 
of science, engineers, chemists, and biologists worked 
together under the direction of a master in hydraulics 
toward one common end — the promotion of the public 
health. . . . 

“ Intelligent bystanders, who saw the sewage flowing 
upon the filters, at the outset unhesitatingly predicted 
failure. They felt certain, and did not hesitate to ex¬ 
press their belief, that in a fortnight, at the latest, the 
filters would become clogged and foul, and the whole 
neighborhood pestilential. They did not know that 
Berlin, the German capital, disposes of all its sewage 
upon the land. They forgot that the farmer, once a 
year, or oftener, manures his fields with filth and that 
the hungry earth receives the gift with open mouth, 
devours it, and soon cries out for more. As soon as a 
few days had passed, and the filters had become estab¬ 
lished, the effluent began to grow bright and clear. 

* Sedgwick, W. T.: Principles of Sanitary Science and the Public Health. 


8 4 


COMMUNITY HEALTH 



SAND FILTERS FOR SEWAGE PURIFICATION 
(Reproduced from State Sanitation, by G. C. Whipple, by courtesy of the 
Harvard University Press) 

Further studies revealed the fact that the foulness of 
the sewage was not held back as by a strainer; but 
rather that, as wood by a slow fire is turned to ashes, 
the organic matters here were slowly reduced to mineral 
substances. No disagreeable odor developed and the 
filters showed no signs of clogging. Thus the very 
name ‘ filter ’ became a misnomer. The bystanders were 
amazed, and could not repress their feelings of surprise 
and admiration.” 

It was discovered that if the sewage was allowed to 
run through the sand continuously the filter would clog 
and become foul. If the filter was used for a day or 
two and then rested for a few days, however, the purifica- 








WASTE DISPOSAL 


85 

tion process was almost perfect. What could be the 
reason that the filter worked better after being rested? 

Here is what the scientists discovered. When the 
sewage began to run through the soil the useful bacteria, 
which carry on the purifying process, collected on the 
top layers of the sand. As they increased in number 
they made a kind of jelly, just as acetic-acid bacteria 
form a jelly which is called “ mother of vinegar.” The 
bacteria of the filter formed a coating of jelly covering 
the grains of sand. All particles of any sort stuck to 
the jelly material and the bacteria purified the sewage. In 
the sand filter, as in the garden, the useful bacteria 
turn the waste substances of plants and animals into the 
mineral substances of the soil. 

These particular bacteria, however, must have plenty 
of oxygen from the air in order to “ breathe.” The air 
which is dissolved in the sewage is not sufficient, and 
the filter must be rested every few days in order to give 
the bacteria the air they need. When the bacteria have 
covered the sand grains with their jellylike growth the 
process of sewage purification becomes rapid and effi¬ 
cient. The water which soaks through the sand is clear. 
In fact, when analyzed by the chemists and bacteriolo¬ 
gists, it is found to be quite pure — as pure as water from 
ponds or rivers. 

Thus science has found out how to speed up the 
process of nature. Because of the presence of so many 
helpful bacteria, the sand filter can do in a few hours 
the work of purification which requires several weeks in 


86 


COMMUNITY HEALTH 


ordinary soil. Such a sand filter, an acre in area, will 
take care of sixty to eighty thousand gallons of sewage 
a day. 

Sprinkling filter. — After the studies at the Lawrence 
experiment station, sand filters were built in many 
towns all over the country. Other studies in sewage 
purification were undertaken, some of which resulted in 
the development of the rock filter or sprinkling filter. 

In this filter a sloping concrete floor with drains is 
first built. Then small broken rocks, an inch or two in 
diameter, are dumped upon this concrete floor until a 
filter about six feet deep is made. The sewage is sprayed 
upon the top of the filter through nozzles which throw out 
a spray like that thrown by a sprinkler upon a lawn. 



A SPRINKLING FILTER 




WASTE DISPOSAL 


87 

In this filter, as in the sand filter, the work is done by 
bacteria. They form their jellylike growth over the 
surface of the rock and purify the sewage as it passes 
through the filter. In this case the process of filtration 
is stopped every few minutes to give the filter a chance 
to “ breathe ”— that is, to allow air to make its way 
between the rocks. The purification process is not quite 
so complete as in the sand filter, but it is much more 
rapid. 

Use of cesspools and tanks. — A quite different proc¬ 
ess of sewage purification is found when the sewage is 
left in cesspools or tanks. In this case useful bacteria 
of quite a different type are at work to change the solids 
of the sewage into liquids. These bacteria are strange 
plants, in that they do not need air. Most bacteria, 
like animals, get from the air the oxygen which keeps 
them alive. The bacteria which grow in cesspools need 
oxygen, too, but they get it from the waste substances 
in the sewage. This bacterial process is called sepsis or 
putrefaction. An example of this kind of bacterial action 
is seen when soup or meat stew “ spoils,” or becomes 
putrid. When kept in a warm place liquids of this sort 
will always spoil if certain bacteria are present. You 
know well enough from the unpleasant odor of spoiled 
soup that the substance of the soup has been changed. 

Perhaps you know of cesspools near houses in the 
country or at a summer cottage. Usually a cesspool is 
built by digging a hole in sand or gravel soil and making 
a wall of railroad ties or big rocks. The house drain. 


88 


COMMUNITY HEALTH 


runs into this pit and the water soaks out into the 
surrounding soil. Cities build large concrete septic 
tanks in which bacteria destroy waste substances in the 
same way as in a cesspool. 

Purification process in one city. — Perhaps you would 
be interested in the story of the way in which one par¬ 
ticular city disposes of its sewage. About sixty-five 
thousand people live in this city, and there is no large 
body of water near at hand into which the sewage may 
be discharged. The sewer pipes run down to the lowest 
land in the city, where there are big pumps which pump 
the sewage two miles into the country to a purification 
plant. Here the sewage is first sprayed upon a sprinkling 
filter. Then it flows through a large tank to sand filters 
where the purification is completed. The water from the 
purified sewage runs into a small brook. 

Although the water which runs into the brook is clear, 
it still contains some dissolved material which serves 
as food for bacteria. Nature continues the purification 
process in the stream. At the place where the drainage 
from the sand filters flows into the brook, there are many 
thousands of bacteria in every thimbleful of water. A 
* little farther down the stream the water is found to 
contain small single-cell animals which feed upon the 
bacteria. These little single-cell animals also have their 
enemies. Many plants and animals play a part in puri¬ 
fying the brook. The bacteria feed upon the dissolved 
material in the water; various animals feed upon the 
bacteria and upon each other. If you study biology and 


WASTE DISPOSAL 89 

chemistry in high school, you will learn more exactly how 
these changes take place. 

There is a motion picture called Waste Disposal in 
Cities which your class may be able to borrow from your 
State Department of Health.* This motion picture 
shows in detail the process which has just been described. 

Reasons for waste disposal. — It is not difficult to 
understand why the body waste must be purified so 
completely. The germs of certain communicable dis¬ 
eases like typhoid fever, cholera, or dysentery are thrown 
off in the body wastes and may find their way to a well 
person through drinking water. Here is the story of a 
typhoid fever epidemic in the city of Plymouth, Penn¬ 
sylvania. It illustrates the danger of failing to dispose 
of body wastes properly. 

In 1885 Plymouth was a mining town of about eight 
thousand people. It had a good water supply, which 
came from a mountain stream, and there were only 
two houses upon the land which drained into this stream. 

On April 9 one of the doctors in town was called to 
see a person who had typhoid fever. Nobody worried 
very much about a few cases of typhoid fever in those 
days, because the disease was rather common. But new 
cases appeared every day. During the week beginning 
May 12 there were from fifty to one hundred new cases 
daily, and it is said that on one day two hundred new 
cases were reported. Imagine the anxiety of the people! 

* Prepared by the authors and available from the Society for Visual Educa¬ 
tion, 327 South LaSalle Street, Chicago, Illinois. 


go 


COMMUNITY HEALTH 


One could not know when his father, or molher, or 
friend, or he himself would come down with the disease. 
Within a few weeks 1104 people had contracted typhoid 
fever and 114 had died. 

What could be the cause of such a widespread epi¬ 
demic? Some thought it might be due to drinking 
polluted well water; others thought it might be due to 
infected milk. Many vague and unscientific notions 
were advanced which were not based upon the then new, 
but sound, knowledge that typhoid fever is a germ 
disease. 

The map which is shown here will help to explain what 
really happened. In one of the houses near the brook 
lived a man who had typhoid fever during January, 
February, and March. The body wastes from this 
patient were not disinfected as they should have been, 
but were thrown out into the snow at some distance from 
the house. The germs remained alive in the frozen 
snow, and when the warm weather of April came the 
snow and the pollution were washed into the brook. 

Even so, the water of the brook might have purified 
itself, and the city might have been saved from the 
epidemic, if there had been a long period of storage for 
the water in the reservoirs. We shall see in a moment 
that the usual period of storage did not exist. 

The story of this epidemic in the First Annual Report 
of the State Board of Health, 1886, explains that there 
had been little water in the reservoirs during the late 
winter. On March 26 there was a thaw, and the brook 


WASTE DISPOSAL 


9 1 



(Reproduced from Sanitary Science and Public Health , by W T. Sedgwick, 
by permission of The Macmillan Company) 
















92 


COMMUNITY HEALTH 


began to rise. The Superintendent of the Water Works, 
in visiting the reservoirs, found the first and second 
reservoirs almost empty. The third was filling rapidly, 
but the discharge pipe was tightly frozen. 

The report says that he caused a fire to be built, which 
melted the ice in this pipe. The water, with its accumu¬ 
lated typhoid fever germs, was discharged from the 
bottom of the third reservoir; it ran down to the second, 
on to the first, and thence was distributed to the town, 
without any storage or purifying process. 

Thus we have the story of “ one patient poisoning 
more than a thousand ” people. Probably the drainage 
from this house had gone into the stream for some time, 
perhaps for years; but when the germs of typhoid fever 
were added to the ordinary pollution this serious epi¬ 
demic took place. 

Sanitation in the country, at cottages, or while camp¬ 
ing. — Water-borne epidemics like the one just de¬ 
scribed show the penalty which must be paid for lack of 
care in maintaining sanitary conditions. Such epidemics 
are very rare now because cities purify sewage and keep 
a careful watch over their water and food supplies. In 
the country the responsibility for waste disposal and 
for getting pure drinking water rests upon individual 
families. There is more typhoid fever in the country 
than in the city at the present time. 

Surely none of us who have learned the importance 
of sanitation will endanger ourselves or other people by 
our carelessness. People who live in the country must 


WASTE DISPOSAL 


93 


be sure that the 
privy is sanitary and 
that there is no pos¬ 
sibility of the well 
becoming polluted. 

Your State Depart¬ 
ment of Health will 
be glad to send you 
material describing 
the construction of 
sanitary privies. In 
any case, the privy 
must be built so that 
flies, rats, or other 
animals cannot get under it and later spread disease. 

People who are camping in the country must be care¬ 
ful not to pollute the water supply, and they must be 
careful to secure drinking water which is pure and un¬ 
polluted. The good camper is careful to leave the camp 
site clean and sanitary in every respect. He burns all 
food scraps which are left. Pasteboard and paper are 
burned. No rubbish is left about. Be a Golden Rule 
camper. 

Review Questions 

1. What is rubbish? Garbage? Sewage? 

2. How do bacteria help in the purification of sewage? 

3. Why must body wastes be properly disposed of or purified? 

4. What rules concerning waste disposal and water supply 

should you follow when you are camping? 



DIAGRAM OF A CESSPOOL 













VIII 


OTHER PROBLEMS OF CITY HOUSEKEEPING 

Is there any health problem involved in keeping pigs, hens, or 
other domestic animals in the country? In the city? 

Why and how do we try to get rid of rats and mice? 

Where do flies breed? 

Why and how do we try to exterminate flies? 

How do cities make war upon the mosquito? 

Is there any reason for making rules to control the types of 
buildings which may be built in different parts of a city? 

Why should a city make regulations concerning the construction 
of houses? 

In order to make a city a clean and healthful place in 
which to live, some one must “ do the housekeeping.” 
If a farmer is careless and slovenly he and his family 
are the only ones to suffer, because neighbors are some 
distance away. In a city people live so near together 
that a man who is careless, or who selfishly disregards 
the welfare of others, seriously interferes with the comfort 
of his neighbors. For example, if a city man keeps 
pigs or hens at the back of his own lot or in a back yard, 
disagreeable odors may trouble his neighbors who live 
nearer the animals than he does. Many cities, therefore, 
do not allow these animals to be kept within city limits. 

You can think of other examples which show the 
necessity of city regulations in the interest of health and 

94 


OTHER PROBLEMS OF CITY HOUSEKEEPING 95 

comfort. We are to consider in this chapter some of 
these sanitary problems. 

Rats and mice. — We try to get rid of rats and mice 
in our homes because they nibble our food if they have a 
chance. They are dirty and destructive pests. The rat 
is more dangerous than the mouse because, in addition 
to being troublesome, it is sometimes the means of 
spreading a disease called “ plague.” 

The spread of plague is an inter¬ 
esting study in animal relations. 

When the plague bacillus gets into 
the body of the rat it causes a dis¬ 
ease (rat plague) which is fre¬ 
quently fatal. But how does the 
germ get from a sick rat to a well 
one? It is carried by the rat flea. 

When a flea bites a sick rat, it picks up the plague 
bacilli. Strangely enough, the bacilli do not cause any 
trouble to the flea. They live and grow in its digestive 
tract. When this flea gets upon the body of a well rat 
it transfers the plague bacilli to a new host, thus spread¬ 
ing the disease. 

How does the rat give the plague to human beings? 
The flea is the culprit in this case. When the flea gets 
upon the body of man and bites, it spreads the disease 
to him. This means that if the rats in a city become 
infected with plague, the people are pretty sure to get 
the disease too. We should remember that well rats do 
not have plague, and that it is only when they do have 




COMMUNITY HEALTH 


96 

the disease that they can pass it on to man. It is possible 
for a city health department to find plague in rats and 
stamp it out by killing them before any person catches 
the disease. 

Cities must try, therefore, to prevent the breeding of 
rats. This is particularly true of cities on the seacoast, 
because there is some danger that rats which have the 
plague may be brought on ships from some other city 
and start the disease among the rat population. Ships 
are usually kept a bit away from the wharf. The ropes 
which hold them in place have rat guards upon them so 
that rats cannot get aboard the ship or leave it by means 
of these hawsers. The rat guards are made of metal; 
they look like a tin pan with a hole in the bottom, 
through which the hawser rope has been pulled. 

Probably you have already rid your house of rats and 
mice by setting traps for them, or perhaps your house is 
so well constructed that no rats or mice ever got into it. 
Even if every house in the city were free from these pests, 
they might still live in stores or factories or old build¬ 
ings. The city tries to prevent the increase in the num¬ 
ber of rats and is continually fighting them by various 
methods. Rats are killed by fumigating old buildings, 
by trapping, or by using poison bait. Some cities have 
rules concerning the construction of buildings, requiring 
that they shall be rat-proof. Other methods of rat 
control are to keep garbage covered so that rats cannot 
feed upon it, and to prevent the accumulation of rubbish 
where rats can gain shelter. 


OTHER PROBLEMS OF CITY HOUSEKEEPING 97 

Fly control. — Can you give the life history of a house 
fly? In Cleanliness and Health you have read that the 
house fly lays its eggs upon animal manure, in garbage, 
or on some other decaying substance. Within a few 
hours the eggs hatch into larvae which are called maggots. 
The maggots eat almost continuously and grow rapidly. 
After four days they turn into pupae. The pupa is a 
resting stage, during which the animal does not feed but 
undergoes a marked change in body structure. At the 
end of about four days more the fly breaks the shell of 
the pupa case and comes out. 

Under favorable conditions for growth, there is a new 
generation of flies every ten or fifteen days. You know 
that flies not only light upon people and food; they also 
visit places of filth. Sanitarians have proved that they 
can carry the germs of certain diseases from one place to 
another. Some towns which have had no sewer system 
have reduced the number of cases of typhoid fever by 
requiring that all privies must be made fly-proof. 

One of the most important ways to combat flies is to 
do away with breeding places. Flies prefer to breed in 
animal manure. The city, therefore, must see that 
stables are properly kept. Either the manure is removed 
every week or something is thrown upon it to prevent 
the breeding of flies. Borax (about ten ounces for eight 
bushels of manure) is commonly used. The use of 
automobiles and trucks instead of horses has helped to 
reduce the number of flies. 

The city often urges a campaign against flies, partic- 


9 8 


COMMUNITY HEALTH 



LIFE HISTORY OF THE HOUSE FLY 


1. Eggs of the housefly 

2. Larva or maggot hatching from 

egg 
j. Larva 


4. Pupa in case 

5. Nearly developed pupa 

6. Mature house fly as seen when walking 

up the outside of a window pane 













OTHER PROBLEMS OF CITY HOUSEKEEPING 99 

ularly at the beginning of the fly season. City regula¬ 
tions require that restaurants and food stores shall be 
properly screened so that the food will be protected 
from flies. They require also that garbage shall be kept 
where it does not allow flies to breed. 

Mosquito control. — You recall from your previous 
study of mosquitoes that they are enemies of both com¬ 
fort and health. Most varieties of mosquitoes produce 
merely discomfort from the sting and the itching which 
follows it. But the Anopheles mosquito transmits 
malaria and the AMes mosquito transmits yellow fever. 
This fact makes mosquito control one of the duties of 
the modern city. Yellow fever is now very rare, but 
there are still many sections of the country where malaria 
is common. In these sections it is particularly important 
for the government to prevent the development of 
mosquitoes. Even in those parts of the country where 
there is no malaria, and where mosquitoes are merely a 
pest, much is now being done to get rid of them. 

How does a city make war upon the mosquito ? — A 
hunter who starts out to kill some kind of animal must 
know something of the nature and habits of the animal 
if he is to be successful. The sanitarian who under¬ 
takes to hunt down the mosquitoes of a neighborhood 
knows the life history of the animal he is hunting. He 
makes war upon the insect at that stage of its develop¬ 
ment which offers the best opportunity to kill the 
greatest number with the least labor and expense. 

You already know something of the life story of the 


IOO 


COMMUNITY HEALTH 


mosquito. You have seen pictures of the different 
stages in its development, and perhaps you have seen 
larvae and pupae themselves and can bring some into 



i. Mosquito eggs floating in water 2. Mosquito larva or wiggler 

(,Shown slightly magnified ) 3. Mosquito pupa or tumbler 

4. Full-grown mosquito 
































OTHER PROBLEMS OF CITY HOUSEKEEPING ioi 

class. The two most important facts in deciding how to 
prevent the breeding of mosquitoes are: (i) mosquitoes 
always breed in water; (2) the larvae and pupae must 
breathe. 

The first attack in the campaign is to destroy the 


A METHOD OF MOSQUITO CONTROL 



102 


COMMUNITY HEALTH 


breeding places of the mosquito. Low land which has 
water standing upon it is drained by digging ditches 
and allowing the water to run off. Small areas of low land 
may be filled in with dirt or ashes and the standing water 
eliminated. 

A second attack is directed against the larvae and 
pupae of the mosquito. They come to the surface and 
stick their breathing tubes out of the water to get air. 
A thin film of crude oil is spread upon the surface of the 
pool. The mosquito larvae and pupae are unable to 
push their breathing tubes through the oil, and die for 
want of air. 

Another way of killing the larvae is by the use of a 
poison, or larvacide. Such a poison, prepared from 
carbolic acid and other substances, is sprayed on the 
water in which the mosquito larvae are developing. 

' There are certain kinds of fish — the top minnow, for 
example — which feed upon the larvae of mosquitoes. 
These fish may be introduced into ponds or sluggish 
streams. When this is done the grass near the banks 
should be cleaned out so that the fish can get at the 
larvae. 

We can do something to combat the adult mosquito, 
but it is more effective to eliminate breeding places or to 
kill the larvae and pupae. Every householder should 
see that rain barrels, gutters, and old cans do not provide 
breeding places. The adult mosquitoes have some 
natural enemies, such as bats and dragon flies. If a 
few mosquitoes get into the house they may be killed in 


OTHER PROBLEMS OF CITY HOUSEKEEPING 103 

the dark corners where they usually stay during the day. 
Good screening will, of course, do much to keep them 
out of the house. 

Swimming pools and bathing beaches. — Who does 
not like to swim? The thrill of the plunge into the 
clear cool water and the joy of vigorous swimming 
furnish real sport. Few activities provide better exer¬ 
cise for all parts of the body or greater enjoyment. If 
we are to enjoy swimming, some one must see that there 
is a good place in which to swim. We cannot have pri¬ 
vate pools of our own, and when we swim in public 
pools, or at the beaches, we want to swim in water 
which is clean. From your previous study of sanitation 
you can understand that it would be possible for 
infections of the eye, the skin, or the digestive tract to 
spread from one person to another in the water of a 
swimming pool. 

We must look to the Health Department to see that 
rivers, lakes, and ocean beaches where swimming is 
allowed are free from sewage pollution. We expect the 
Health Department to examine and know the quality of 
these waters. We expect them to know the quality of 
water in public swimming pools and to prescribe rules 
for the operation and conduct of these places. For¬ 
tunately indoor and outdoor swimming pools are now 
becoming so numerous that most people have some 
opportunity to enjoy the sport of swimming. We must 
depend upon the city to keep these swimming places in 
proper condition. 


104 


COMMUNITY HEALTH 


It would be too expensive to have clear water running 
through indoor swimming pools continuously, and yet 
the water must be kept clean. Usually it is pumped out 
of the tank and purified by means of a sand filter, chlo¬ 
rine gas, or ozone, and then allowed to flow back into 
the tank. At indoor pools there are usually rules which 
require the bather to take a cleansing bath with soap and 
water before swimming. Each individual should look 
upon this as his share of responsibility in helping to 
keep the pool clean. Bathing suits and towels which 
are supplied to bathers are thoroughly clean and properly 
disinfected. 

Housing. — Can you think of any one thing which is 
more important to the health and happiness of an 



ATTRACTIVE HOUSING 






OTHER PROBLEMS OF CITY HOUSEKEEPING 105 

individual than the right kind of home? Some members 
of the family spend more time in the home than others, 
but every one spends more time at home than anywhere 
else. Of course, the home is more than merely a house 
in which to live. The love and life of the family are the 
most important elements of the home. A poor cottage 
may be a happy home, while a costly mansion may 
shelter an unhappy family. The cost of the house does 
not determine the amount of happiness, but it is true 
that a house which is comfortable, cozy, attractive, and 
healthful will add to the well-being of the family. 

If you were going to select a house in which to live, 
what are the things you would look for? You would 
want all of the rooms to be light and airy. The house 
should be heated so that it would be comfortable in t;old 
weather. You would insist upon a supply of safe drink¬ 
ing water, a sanitary toilet, a convenient place for 
laundering, and a well-appointed kitchen. The plumbing 
should be in good condition, and the house should be 
free from cockroaches, bugs, rats, and mice. It should 
have proper exits in case of fire. 

What does a city government have to do about housing? 
One would think that the people who were going to live 
in a house would demand proper sanitation. Most 
people who build their own houses, or who pay fairly 
large rent, do insist upon sanitary conditions. There 
are people, however, who have not yet learned the value 
of good air, sunlight, and sanitation. Some people have 
so little money that they are likely to take the least 


io6 


COMMUNITY HEALTH 



Courtesy of the American Child Health Association 

LESS DESIRABLE HOUSING 

expensive rent without considering its dangers, although 
the cheapest rent will not be the cheapest in the end if it 
causes sickness in the family. 

It is important for the city to make rules and regula¬ 
tions governing the construction of houses, so that there 
will be no dark rooms without ventilation and so that 
the plumbing and other sanitary fixtures of the house 
will be satisfactory. If it were not for such rules, en¬ 
forced by visits of inspectors, in every large city there 
would be people living in places entirely unfit for human 
habitation. 









OTHER PROBLEMS OF CITY HOUSEKEEPING 107 

Other health problems. — Other activities of the city 
which have to do with the comfort, health, and safety 
of the people include the cleaning and proper lighting 
of streets. In some cities it may be necessary to prevent 
an excessive amount of dust or smoke. It is possible 
that sometime steps will be taken to reduce the amount 
of noise. Perhaps you can think of some other health 
problems which relate to city housekeeping. 

Questions, Problems, and Projects 

1. Is your house protected against the entrance of rats and mice? 

2. What can one do to get rid of rats and mice about a house? 

3. Inspect your community for fly-breeding places. 

4. What is done in your city to fight mosquitoes? 

5. Inspect your community for mosquito-breeding places. 

6. Can you find out what is done to protect places where you 

swim? 

7. Why is it important for every one to take a soap and water 

bath before going into a swimming pool? 

8. Secure from your city Health Department the regulations 

governing housing. 


IX 


KEEPING PEOPLE WELL 

What ideas have been held in the past as to the nature of disease? 

Is the average length of life increasing or decreasing? 

What are the weapons in the warfare against disease? 

Why is it that a person who has had a certain communicable 
disease will not catch it again? 

What is immunization? 

Have you ever wondered what the people of different 
nations have done at various times in history in their 
attempts to keep well? Health, of course, has always 
been one of the most prized possessions of man. Per¬ 
haps some of you are already familiar with customs in 
other parts of the world which were, or still are, different 
from our own. Keeping people well has been under¬ 
taken in a scientific way for only a few generations. 
Modern public health work has been developed, for the 
most part, since the time of Louis Pasteur. 

Early ideas of disease. — The records of primitive 
peoples show that they believed all kinds of diseases to 
be due to evil spirits or demons. Even today the un¬ 
civilized tribes in Africa try to keep themselves well and 
to cure their diseases by the spells and magic of witch 
doctors. The medicine man of the American Indians 
used magic to cure diseases, to bring rain for the harvest, 
and to protect the members of his tribe from injury. 

108 


KEEPING PEOPLE WELL 


109 



PRIMITIVE PEOPLE BELIEVED DEMONS TO BE 
THE CAUSE OE DISEASE 

From the time of the Egyptians, the Persians, the 
Greeks, the Romans, through the history of the different 
peoples of Europe during the Middle Ages, charms, spells, 
magic words, and talismans were used to keep people 
well and to cure disease. The Greeks sought the aid of 
special gods and goddesses. ^Esculapius was the god 
of medicine; his daughter, Hygeia, was the goddess of 
health; and her sister, Panacea, was called the All- 
Healer. Although the Greeks prayed to these heathen 
deities, they also used magic spells and verses, for in 
those days the art of healing was so much mixed up 
with both magic and religion that the three things 




no 


COMMUNITY HEALTH 


could not be separated. Our own ancestors, not many 
generations ago, thought of magic as one of the chief 
ways of keeping people well. 

Even seventy-five years ago there were many mis¬ 
taken ideas about the nature of disease which made it 
impossible to prevent diseases as we do today. Malaria 
was believed to be due to bad air, until scientific re¬ 
search showed that it is produced by the bite of the 
malarial mosquito. Diphtheria and typhoid fever were 
wrongly thought to be caused by disagreeable odors. 
Until the miscroscope was perfected, there was no way 
by which man could find the tiny parasites which cause 
the communicable diseases. 

Scientific knowledge of disease. — During the last 
three generations the prevention and cure of disease 
have become a science. We now know that there are 
two kinds of diseases. Communicable diseases make 
up the first group, and they are caused by living parasites 
which get into the body. The second group of diseases is 
made up of those which occur when something goes 
wrong in the body mechanism itself. Public health and 
personal hygiene help us to prevent all these diseases, 
and modern scientific medicine helps us to cure them. 
Our knowledge of the true causes of disease has removed 
much of the fear, anxiety, and worry which our an¬ 
cestors felt. We know how to live in order to keep 
well. 

Every animal has its natural enemies. The owl is an 
enemy of the rabbit, the cat is an enemy of rats, the 


KEEPING PEOPLE WELL 


hi 


wolf is an enemy of cattle. We know from a study of 
natural history that wild animals may attack man, but in 
this day of cities they rarely get a chance to do so. Even 
the people who live in the great woods do not fear them, 
because, knowing the habits of an animal, they know 
how to protect themselves. So it is with a few tiny 
plants and animals (parasites) which are our enemies. 
We have now learned to wage successful war against 
them. The scientist is the general in this war. He 
knows the nature of the enemy and how the enemy 
attacks. He beats his foe at every turn. Epidemics 
(from the Greek words epi , meaning “ upon,” and 
demos , meaning “ people ”) are becoming more and more 
rare. Science will ultimately free us from many of our 
our present-day diseases. 

The average length of human life is rapidly increasing. 
A minister named Edward Wigglesworth studied the 
length of life in New Hampshire and Massachusetts in 
1789 and made a table which showed the expected length 
of life to be just a little over twenty-eight years.* An¬ 
other table, made in 1855, showed the expected length 
of life in the state of Massachusetts to be almost forty 
years. At the present time the expected length of life 
in the United States has increased to over fifty-six 
years. You may wish to reckon the percentage of in¬ 
crease in the length of life between these periods, or to 
make a graph showing how the length of life has 

* Ravenel: A Half-Century in Public Health. American Public Health 
Association. 


112 


COMMUNITY HEALTH 


increased. Longer average life has come in part through 
conquering the communicable diseases. Jenner con¬ 
quered smallpox by the discovery of vaccination. 
Pasteur, Walter Reed, Behring, Trudeau, and other 
health heroes have added to life and health by their 
scientific discoveries. 

Today there are three important factors in keeping 
people well: (i) we practice health habits; (2) capable, 
scientific doctors give us regular physical examinations, 
health advice, and treatment; (3) the health depart¬ 
ment under the government maintains healthful living 
conditions. 

Imagine that you are the health officer of a city. The 
health of the people is in your hands, much as the health 
of soldiers is in the hands of the commanding officers. 
What could you do to keep people well? Probably you 
would look first for those enemies against which we have 
special weapons; you would attack the diseases which 
we know how to stamp out. 

Insect control. — One of the things to be undertaken, 
especially if you are in the South, would be mosquito 
control, because this would eliminate two diseases, ma¬ 
laria and yellow fever. Malaria cannot be spread unless 
(1) some one has malaria; (2) an Anopheles mosquito 
has a chance to stab the malaria patient; and (3) several 
days later the same mosquito has a chance to stab a 
well person. 

The life history of the malaria parasite is pictured 
in the illustration on page 114. The chart shows: 


KEEPING PEOPLE WELL 



LOUIS PASTEUR 

Father of the Modern Science of Disease Prevention 



COMMUNITY HEALTH 



IN MAN AND IN MOSQUITO 


(1) a highly magnified malaria parasite in the form 
in which it goes into the blood from the mosquito; 

(2) a red blood corpuscle, highly magnified, in which the 
malaria parasite is living; (3) a group of young parasites 


LIFE HISTORY 

of ° 

MALARIA 

PARASITE 


HEAD o/'MALE 
MOSQUITO 




®o© 





































KEEPING PEOPLE WELL 115 

which have been produced in the blood; (4) a form of 
the parasite in the stomach of the mosquito; (5) pic¬ 
ture of the stomach of the mosquito showing the little 
swellings caused by the growth of the malaria parasite; 
(6) a single parasite as it comes from the stomach of 
the mosquito and makes its way to the mosquito’s 
salivary gland; (7) picture of the salivary gland of the 
mosquito. From the salivary gland the parasite goes 
to the mouth of the mosquito. 

In combating malaria we use a substance (quinine) 
which kills the malaria parasite in the blood. If a person 
has to go to a section of the country where malaria is 
present he can protect himself by taking quinine reg¬ 
ularly. If he fails to protect himself he can be cured by 
quinine, although the cure is more difficult and unpleasant 
than prevention. Is it not wonderful that quinine, 
prepared from the bark of a tree, should contain such 
protecting and curative powers? 

If you were a health officer would you try to get rid 
of house flies as well as mosquitoes? What reasons are 
there for doing so? How would you go about it? 

Immunization. — There are other means of protecting 
people from particular diseases. You know that people 
do not usually have measles more than once. This is 
true for many other diseases. We say that a person who 
cannot catch a disease is immune to it. Do you know of 
any way by which a person can become immune to 
disease without having had the disease itself? “ Yes,” 
some one will say, “ it is possible to be protected against 


n6 


COMMUNITY HEALTH 


smallpox, diphtheria, and typhoid fever by immuniza¬ 
tion.” 

How is immunity produced? When germs get into the 
body and cause disease, there is a battle between the 
germs and the body. The germs produce substances 
which injure the body, and the body produces substances 
which kill the germs. If the body produces enough of 
the right kind of substance the germs are killed, and some 
of this protecting substance stays in the body. 

All immunization is based upon this principle. In 
vaccination and other forms of immunization, weakened 
or killed germs are introduced into the skin. They cause 
only slight discomfort, but the body produces the 
desired protecting substances. 

Let us illustrate this principle by using diphtheria as 
an example. The diphtheria germ produces toxin and 
the body produces antitoxin. The antitoxin is found 
in the clear fluid (serum) of the blood. The antitoxin 
which the doctor uses in curing diphtheria is made in 
the blood of the horse. 

Immunizing the public. — Perhaps you wonder why 
vaccination and other forms of immunization are 
problems of community health. You may think that 
each person should have himself protected, and that 
the government should not need to do anything about 
it. There are several reasons, however, why the Health 
Department urges immunization. Can you think of 
some of them? For one thing, people are careless, and 
unless some one reminds them of the need of protection 


KEEMNG PEOPLE WELI 



Courtesy of Metropolitan Life Insurance Company 

EMIL VON BEHRING (1854-1917) 
Discoverer of Diphtheria Antitoxin 




n8 COMMUNITY HEALTH 

they forget it or put it off until they actually have the 
disease. Moreover, many people do not understand 
immunization and, left to themselves, they would never 
think of having it done. Sometimes people who have 
never taken the trouble to learn the real truth about 
immunization advise others against it. Such advice 
carries great responsibility, does it not? If a person 
refused immunization because of your wrong advice 
and later caught the disease and died from it, how would 
you feel about it? 

There are two diseases which we could wipe out 
entirely by means of immunization. These are smallpox 
and diphtheria. There is protection against certain 
other diseases, but these two could and should be driven 
from the face of the earth. 

Smallpox control. — If every little child were properly 
vaccinated against smallpox the disease would disappear. 
Doctors recommend that children should be vaccinated 
before they go to school, and that the vaccination should 
be repeated in from seven to ten years. Have you been 
vaccinated? Do you remember your vaccination? What 
was it like? Is it now time for you to be vaccinated 
again? 

Many states and cities require children to be vacci¬ 
nated before they are admitted to school. In such 
places smallpox epidemics do not occur, and there are 
cases of the disease only when some one brings it in. 
Where vaccination is not enforced, however, there are 
sometimes many cases. In one of the great cities of the 


KEEPING PEOPLE WELL 119 

United States there were 1508 cases and 140 deaths from 
smallpox during the first six months of the year 1924. 
Yet no person who had been successfully vaccinated 
within the previous five years contracted smallpox. 
More than 800,000 people were vaccinated in that city 
to stop the epidemic. The 140 lives would have been 
saved if the city had kept up compulsory vaccination. 
It is the duty of every citizen to learn the facts regarding 
vaccination and to see that the right laws are kept in 
force. 

Diphtheria control. — The following story illustrates 
how diphtheria may be controlled. Mary Brown was 
ten years old. She came into the house one day and 
told her mother that she did not feel well. Her throat 
was sore; it hurt. What should be done? Her mother 
noticed that Mary’s flesh was hot and that the inside of 
her throat was red and swollen. She sent immediately 
for the family doctor. He said that it looked as though 
Mary was coming down with diphtheria, and that it 
was advisable to give antitoxin right away. 

“ Antitoxin does not hurt a person, anyhow,” he said to 
Mary’s mother, “ and if the disease proves to be diph¬ 
theria, antitoxin is a sure cure, provided it is given early 
enough.” 

The doctor wanted to make certain whether it was 
actually diphtheria, so he took bacterial cultures from 
Mary’s nose and throat and sent them to the Health De¬ 
partment laboratory. The bacteria in the cultures were 
allowed to grow overnight. In the morning the labora- 


120 


COMMUNITY HEALTH 



Courtesy of Milbank Memorial Fund 

LITTLE CHILDREN SHOULD BE VACCINATED AGAINST SMALLPOX 
AND IMMUNIZED AGAINST DIPHTHERIA 

tory worker examined the bacteria under the microscope 
and found diphtheria germs present. 

The doctor was now sure that Mary had diphtheria. He 
knew just what to do for Mary, and he protected the 
other members of the family so that they would not catch 
the disease. Mary was not very sick, because she had 
received antitoxin early. Her father and mother had 
only one regret. They realized that they could have 
had her immunized so that she would never have caught 
diphtheria at all.* 

* This story'is told in a moving picture entitled Conquering Diphtheria, 
prepared by the authors for the Society for Visual Education, 327 South LaSalle 
Street, Chicago, Illinois. You may be able to borrow it from your State De¬ 
partment of Health. 




KEEPING PEOPLE WELL 


12 I 


It is important to have children immunized against 
diphtheria when they are very young. When parents 
have all babies immunized soon after they are nine 
months old, there will be no more cases of diphtheria. 
Several cities in the United States have already immu¬ 
nized most of the children. Some of these cities have 
not had a case of diphtheria for several years. 

Protection against other diseases. — There are other 
diseases for which immunization has been developed. 
One may be protected against typhoid fever by vaccina¬ 
tion. This disease can be nearly eliminated by proper 
sanitation, as you have learned in previous chapters. 
If, however, you are going into the woods or into the 
country where the sanitary control is poor, it is particu¬ 
larly important that you should be vaccinated against 
typhoid fever. 

Scarlet fever is a disease for which we have control 
methods similar to those used for diphtheria. Scientists 
are constantly at work in the attempt to discover a 
method of immunizing people against other diseases. 

State and local Health Departments provide vaccines 
and immunizing substances for physicians and help 
physicians by making laboratory tests. 

Quarantine and isolation. — Health Departments also 
protect people through quarantine and isolation. When 
a person has been exposed to a communicable disease 
he may be quarantined. The word “ quarantine ” 
comes from the Italian word meaning “ forty,” and 
refers to the fact that the ships of long ago were kept in 


122 


COMMUNITY HEALTH 


the harbor for forty days before any of their passengers 
were allowed to land, whenever there had been cases 
of communicable disease on board during the voyage. 
We quarantine a person who has been exposed to a 
communicable disease by keeping him away from other 
people. 

Isolation means keeping by one’s self. When a person 
actually has a communicable disease every one except the 
nurse is kept away from the sick room. The good 
citizen respects the rules of quarantine and isolation, and 
keeps away from houses in which there is communicable 
disease. 

It is necessary for the Health Department to keep a 
careful watch over communicable disease. Whenever a 
case occurs it must be reported to the Health Depart¬ 
ment at once. The patient is isolated and the people 
who have already been exposed are quarantined, unless 
they are immune to the disease. 

Sanitation. — What have you learned about the value 
of sanitation in the prevention of communicable dis¬ 
ease? You have seen in the study of water, milk, and 
foods that sanitation is an important weapon which the 
city uses to protect the health of its citizens. From 
your study you could make a list of the ways in which 
sanitation may be used in the battle of science against 
disease. 

Education in health. — Another way of helping people 
to keep well is to show them how to do it. Every one 
should know that red eyes, flushed face, running nose, and 


KEEPING PEOPLE WELL 


123 



DO YOU RESPECT THE RULES OF ISOLATION? 

a cough are the early symptoms of many catching dis¬ 
eases. A person who is well nourished and free from 
fatigue, who gets sunlight and fresh air, and who is in 
general good health, is not likely to catch cold or to have 
tuberculosis. If Health Departments can explain such 
things to people and help them to follow the rules of 
health, diseases will be less common. 

Moreover, people get sick from many diseases which 






































124 


COMMUNITY HEALTH 


are not catching at all. There are disorders of the diges¬ 
tive tract, the kidneys, or the liver. There are various 
troubles caused by improper posture and the wrong use 
of the body. Nervous disorders develop because people 
overwork and fail to have enough rest and wholesome 
recreation. The body is like an automobile; it must 
have reasonable attention or some part goes wrong. A 
new part cannot be substituted in the human body as 
it can in an automobile. 

The annual physical examination is an important aid 
in keeping well. Such an examination enables a person 
to find out from the doctor whether he is perfectly 
sound. If a defect starts to develop, it may be discovered 
and corrected before it becomes serious. 

Review Questions 

i . Now answer the questions at the beginning of the chapter. 

2. How do the present methods of keeping people well differ 

from those of a few hundred years ago? 

3. What is the health value of insect control? 

4. What is meant by toxin? Antitoxin? Epidemic? Quaran¬ 

tine? Isolation? Sanitation? 

5. What diseases could be completely wiped out? How? 

6. What are the responsibilities of a citizen in the control of 

communicable disease? 

7. Should he report a case which has not been reported to the 

Health Department? 

8. What is his part in helping to maintain isolation? 

9. What danger is there in being near people who have red 

eyes, running nose, a flushed face, or a cough? 

10. Why is it important to obey quarantine and isolation rules 

and make other people obey them? 


KEEPING PEOPLE WELL 


125 


Problems and Projects 

1. Perhaps you would like to discuss the relative value of the 
following weapons for fighting disease: 


1. Insect control 

2. Quarantine 

3. Isolation 


4. Immunization 

5. Sanitation 

6. Education 


2. You might like to learn more of the conquest of disease by 

studying the lives of such health heroes as Louis Pasteur, 
Edward Jenner, and Walter Reed. 

3. Secure from your local Health Department the rules for 

disease control and discuss them in class. 

4. Motion pictures on the prevention of diphtheria, smallpox, or 

other diseases may be secured through your State De¬ 
partment of Health. 


X 


VENTILATION 

What is good ventilation? 

What is meant by window ventilation? 

What is meant by mechanical ventilation? 

What are the effects of air upon the body? 

What is the relation of sunlight to health? 

Most animals except man live out of doors. Man 
lives in heated houses. A few centuries ago most men 
worked out of doors, but now a majority of them work 
in stores, factories, shops, or other buildings. The 
Indian boy spent his days out of doors. You spend your 
days in the schoolhouse. Because we live in buildings 
which keep the wind from blowing upon us, we need to 
ventilate our rooms. Ventilation comes from the Latin 
word ventus, meaning “wind.” It is the process of getting 
fresh air into buildings. 

You have learned from your earlier studies of health 
something about the way in which the body keeps the 
same temperature. The human body remains at 98.6° F. 
in the Arctic circle or in the tropics. You yourself have 
experienced the discomfort of being too cold and the 
discomfort of being too warm, and yet under extreme 
conditions of heat and cold the healthy body does not 
change temperature very much in either direction. 
Good ventilation provides air which has a stimulating 

126 


VENTILATION 


127 



FRESH AIR IS INVIGORATING 


effect upon the skin and allows the body to keep the 
proper temperature without too much effort. 

Have you not enjoyed the presence of fresh air and 
suffered from its lack? How invigorating it is to walk or 
play out of doors! How wide-awake you feel in winter 
when the cold out-of-door air strikes your skin and 
puts color into your cheeks as you hike or slide or skate! 
How dull, lifeless, and sleepy you feel when you have 









128 


COMMUNITY HEALTH 


been sitting in a hot room for a long time! In the sum¬ 
mer, when the weather has been hot and sticky, how 
much better you feel if a breeze comes up! 

It is easy to understand the cooling effect of the air 
as it comes in contact with the skin. The more rapidly 
the air is moving and the cooler it is, the more the body 
is cooled by it. When the air becomes too cold we get 
behind a shelter, out of the wind, or we go indoors; we 
build a fire or we put on more clothes. In summer, 
when it is warm, we go out of doors; we try to find a 
place where there is a breeze; we wear lighter clothes; 
we fan ourselves; we perspire. 

The process of perspiring is more important than the 
other factors in keeping cool. It is nature’s method of 
cooling off the body. When we perspire, water comes 
from the sweat glands and the skin is wet with the 
perspiration which stands in little drops. It is turned 
into vapor and passes off into the air. That process is 
called evaporation, and it uses up heat from the body. 

If you want a simple illustration of the cooling process 
of evaporation, put a drop of ether or a drop of alcohol 
on the back of your hand. You will notice that it feels 
cool. This is because ether and alcohol evaporate 
rapidly. If you put just a bit of water on your hand 
and fan it vigorously you will notice that the spot 
where the water is feels cooler than the rest of the 
hand. Perspiring, with the evaporation which follows, 
is the most important method of cooling the body when 
it is hot. 


VENTILATION 


129 


Effects of poor ventilation. — Let us see what happens 
when the body is unable to cool itself. The following 
story tells the famous incident of “ The Black Hole of 
Calcutta.” 

In the year 1756, Fort William in Calcutta, India, was 
captured by the ruler of the Province of Bengal. The 
soldiers who were still in the fort when it surrendered 
were driven into the guard room. There were 146 men, 
who were pushed into a room about twenty feet square, 
having only two small windows barred with iron. If 
you mark oh a square on the floor which is eighteen 
inches on each side, you will have about the amount 
of space that each man had to stand upon. 

Very soon after they were put into the room they 
began to perspire. They suffered severely. They 
became wretched. They threw insults at the guards, 
hoping to make them angry so that the guards would 
shoot them and end their misery. At six o’clock in the 
morning an order came for their release. Only twenty- 
three of the 146 men were still alive, and they were so 
weak they could hardly move. Most of the twenty- 
three survivors suffered from fever. 

The men who died were killed by heat stroke. There 
was no way for fresh air to get to their bodies and cool 
them off by taking away the heat which the body is always 
manufacturing. If the conditions of the “ Black Hole of 
Calcutta ” were repeated today, except that a strong 
electric fan were blowing air down upon the men, 
probably no one would die. 


COMMUNITY HEALTH 



130 


WHICH BOY IS GIVING HIS SKIN PROPER VENTILATION? 

In the study of physiology we learn in more detail 
how the body loses heat. Studies on ventilation have 
shown what happens when a person is put in a room 
where the air is very hot, moist, and still. The person 
becomes restless and irritable. The heart beats faster. 
A headache begins. The person becomes thirsty. The 
eyes get red and sore. There may be a feeling of weight 
on the chest, and the person may even become dizzy. 
After coming out of such a hot chamber the person feels 
tired and “ fagged out.” 

Such studies show that a person following his own 
inclination is likely to do less work, either physical or 
mental, in a warm room than in a cool one. He gets 
tired quickly in a warm room and does not feel well. 
On the other hand, if he is in cool air he feels like work¬ 
ing; the body produces more heat and uses up the food 
which he has eaten. His appetite is better; his circula¬ 
tion and breathing are improved. 































VENTILATION 


I 3 I 

It appears also that a person’s resistance to common 
cold is greater if he lives in properly ventilated rooms 
than if he lives in overheated rooms. Studies by the 
New York Ventilating Commission, which were con¬ 
ducted with sixty-five hundred school children in the 
city of New York for a period of two or three months in 
two succeeding winters, show that the children in 
properly ventilated rooms had 18 per cent less absences 
through colds and 70 per cent less colds than the pupils 
in rooms which were too hot and poorly ventilated. 
These facts show the importance of having fresh air 
continuously. 

The air in which we live indoors should be slightly 
changing, like the out-of-door air. If it is exactly the 
same, hour after hour, in its temperature, its rate of 
movement, and the amount of moisture it contains, 
there is little stimulating effect. If it is slightly changing, 
the skin will continually react to these changes, and the 
body will feel better for these reactions. 

What is fresh indoor air? The air in good ventilation 
has the following five qualities: (1) moderate tempera¬ 
ture; (2) gentle motion; (3) a moderate amount of 
moisture; (4) a slightly varying temperature; (5) free¬ 
dom from dust and odors. 

It is not safe to rely upon comfort alone in deciding 
what is good air. A person may easily acquire a taste 
for something which is not good for him. After you have 
just eaten candy, you have no taste for milk or vege¬ 
tables, although you know that they are better foods than 


1 3 2 


COMMUNITY HEALTH 


candy. In the same way people often get used to rooms 
which are much too hot. The skin loses its vigor and 
the body does not adjust itself readily to the cooler 
temperatures which are much more healthful. 

Types of ventilation. — Since ventilation is so im¬ 
portant to health the problem of getting fresh air into 
our homes, schoolhouses, factories, and public buildings 
is an important problem in community health. Let us 
see what is necessary in order to have fresh air in our 
homes and schools. 

There are two widely different methods of ventilat¬ 
ing. One is by window ventilation, and the other is by 
mechanical ventilation. There are many modifications 
of these two principal methods. The engineering details 
of ventilation cannot be studied in this class; but it is 
possible for us to learn something of general principles. 

Window ventilation. — There is some disagreement 
still concerning the best way to ventilate rooms, but 
studies on ventilation in both the United States and 
England seem to favor window ventilation. In this 
type of ventilation the room is heated by radiators, and 
the cool outside air enters continuously through open 
windows. This is the system which is most commonly 
used in homes. In summer the windows are wide open. 
In winter, when the air outside is very cold, one can 
feel the cool air coming in around the closed windows. 
In fact, so much air enters in this way that it may not 
be necessary to raise the window more than a crack in 
order to get plenty of fresh air. 


VENTILATION 


133 


In straight window ventilation the fresh air comes in 
at the bottom of the window and the warm air goes out 
at the top. You have all been taught to open the win¬ 
dow at top and bottom when you go to bed at night. 
This secures the best circulation of air. We cannot 
open the windows wide at top and bottom in our living 
rooms in the winter because it would be too cold. It is 
not very difficult to ventilate a house, because there 
are usually windows on two sides of the room, and there 
are many doors. Air enters through the walls and around 
the windows, so that a large amount of fresh air finds its 
way into the house in cold weather. 

There are some disadvantages to straight window 
ventilation in large rooms. The air may not circulate 
sufficiently if only one window is used. If two windows 
on opposite sides of the room are open, there may be a 
draft, and usually the floors are cold. 

In the schoolroom with windows on only one side, 
these difficulties from window ventilation are increased. 
It is now usually recommended that window ventila¬ 
tion in schoolrooms be improved by adding ducts or pipes 
which run from the room to the roof to carry off the 
hot air. 

Beneath the windows there are radiators which 
furnish heat. As the cool air comes in where the window 
is raised at the bottom, there is a window board which 
starts the air up toward the ceiling. If it were not for 
this window board the cold air, which is heavier than 
warm air, would slide over the window sill and drop 


I 34 


COMMUNITY HEALTH 



wvrufaw- 


directly to the floor. With the arrangement shown in 
the picture the cold air is obliged to climb over the top 
of the window board, where it meets the warm air which 
is coming up from the radiators. Such a process keeps 
the air in the room in motion and provides a constant 
supply of fresh air. 

The warmest air in the room will always be found 
nearest the ceiling, and it is near the ceiling that we 
find the vent opening into the pipes which go to the 
roof. The warm air goes out through these pipes, allow¬ 
ing the continual supply of fresh air to come in through 
the windows. % 

This kind of ventilation can be controlled within the 
classroom. In many rooms the steam in the radiators 
can be turned on and off, and it is always possible to 


























































VENTILATION 


135 



CONTROL THE TEMPERATURE IN YOUR CLASSROOM 

raise or lower windows. On very cold days the windows 
will need to be open only the least crack. On warmer 
days the windows will be open wide. 

Of course a room will not adjust itself as the weather 
changes. Every room needs attention to keep it from 
getting too hot at times and too cold at others. The 
best plan is to have some pupil directly responsible for 
the ventilation. A temperature chart can be kept on 
the blackboard or on paper beside the thermometer. 
The pupil will read the thermometer at regular times 
each day and record the temperature. When the tern- 











































COMMUNITY HEALTH 


i3 6 

perature is too high the room will be cooled by opening 
the windows. The best plan is to keep the room at 
temperatures of about 65° to 68° F. The temperature 
may go somewhat lower than this, but it ought not to 
go higher. 

You have no doubt heard of open-air classes for 
children who are not very strong. They are taught out 
of doors or in a room where windows are taken out or 
kept open. People in tuberculosis hospitals, and people 
sick with some other diseases, are kept in the open air 
continually. If fresh air will help to cure these people, 
surely it will help to keep us well. 

Mechanical ventilation. — The other type of ventila¬ 
tion is called the mechanical system. In this system 
the air from out of doors comes in through a heater 
where it is heated to a temperature of from 70° to ioo° F. 
Fresh air is then mixed with it to give the desired 
temperature, and the mixed air is sent into the room. 
This hot air is blown into the rooms by a set of fans 
which work like electric fans, except that they are inside 
of pipes and pull the hot air along rapidly. The hot air 
rises to the ceiling as it enters the room. The cool air 
from the floor goes into an outlet pipe, which may or 
may not have a set of fans to pull it along faster. 

There are some disadvantages to this kind of ventila¬ 
tion. The air coming into the room is always of the 
same temperature, and therefore lacks the variation 
which is found in out-of-door air. The fan-driven air 
moves more rapidly, and the room must be kept at a 


VENTILATION 


*37 

higher temperature for comfort. Because of the different 
room conditions, as to sunlight and outdoor exposure, 
it is difficult to distribute the air in a way which keeps 
all the rooms comfortable. 

Sunlight. — We should remember that some of the 
health value which comes from being out of doors is 
derived from sunlight. You recall that sunlight will 
prevent rickets. The body is able to use the energy of 
the sun in some way for maintaining health and vigor. 
Exactly what takes place is not known. Scientists tell 
us that the ultra-violet rays of the sun are the most 
healthful, and that we lose the benefit of these when the 
sunlight passes through ordinary window glass. Ultra¬ 
violet light will not pass through ordinary glass. Fresh 
air and sunlight are wonderful gifts of nature for the 
stimulation of life and the preservation of health. 

What is your responsibility in regard to air and 
sunlight? 

Questions and Projects 

1. What does ventilation mean? 

2. What are the effects of poor ventilation? 

3. What experiences have you had in different kinds of venti¬ 

lation? 

4. Make a chart showing the differences between window 

ventilation and mechanical ventilation. 

5. How is your house ventilated? 

6. At what temperature is it kept? 

7. Organize the class to keep a record of classroom temperature 

and adjust ventilation conditions. 

8. How is your school building ventilated? Arrange for a trip 


COMMUNITY HEALTH 


138 


to see the school heating plan when the custodian can 
explain to you how it operates. 

9. If some pupils have access to the ventilating system of some 
other public building, let them report upon it. 

10. Perform ventilation experiments, using a chalk box arranged 
like the one shown in the picture. Use a one-inch candle 
and see with which combination of openings it burns best. 
The candle may go out for want of oxygen. The body 
will always get enough oxygen; but we need fresh air on 
the skin. Is there any advantage in having a window 
opened at the top and bottom? 



MAKE A BOX LIKE THIS FOR VENTILA¬ 
TION EXPERIMENTS 














XI 


INFANT WELFARE 

Does the care of a baby affect his health in later life? 

What are the important rules for the care of babies and little 
children? 

What responsibilities do parents have for the health of the child? 

What is the responsibility of the community for the health of 
little children? 

A marked difference between man and the lower 
animals, in respect to bringing up the young, is the 
amount of time required. Puppies and kittens are 
ready to shift for themselves in a few months. Indeed, 
mother-love usually lasts only through the period when 
the young animal is dependent upon the mother for food 
and protection. How different with human beings! 
Even after ten years of home care a young human is 
still quite unprepared to take care of himself, although 
he may manage somehow if he is actually thrown upon 
his own resources. Man does not reach his complete 
development until he is twenty-one, and he is usually 
considered unable to take care of himself until he is 
at least sixteen years old. 

Think for a moment what a child does during this 
long period of development. He should be brought up 
in such a way that he comes to manhood with a strong, 
healthy body. He learns from parents, teachers, friends, 
139 


140 


COMMUNITY HEALTH 


and from his own experi¬ 
ence, the skills of mind 
and body which he needs 
in later life. He grows 
in intelligence and under¬ 
standing. Out of his own 
experience with other 
people in home, school, 
and neighborhood, he 
learns the desirability of 
honesty, sincerity, loy¬ 
alty, industry, unselfish¬ 
ness, and all those other 
qualities of behavior 
which add to content¬ 
ment in life. His devel¬ 
opment must be along 
several lines — physical, mental, social, and moral — if 
it is to be complete. This long period of growth is a 
preparation for the rest of life, but it is such a happy 
time for most of us that we think childhood is worth 
living just for its own sake. 

You may be surprised to know that the most rapid 
period of development is during the earliest years. The 
rate of growth of a baby is greatest during his first month 
of life, when his weight increases over 20 per cent. The 
rate of growth becomes less as he gets older, and during 
the twelfth month he increases in weight a little less 
than 3 per cent. It takes only from seven to eight 




INFANT WELFARE 


141 

months for the baby to double its weight. What fraction 
of your weight did you gain during the past eight months? 
During the first six years a child doubles his height and 
increases his weight fourfold. 

The rate of mental growth is also greatest with the 
infant, and becomes less as he gets older. Just think 
what the baby learns in two or three years. He learns 
to use his eyes and ears, to handle things, to walk, to 
talk, and to understand others. One of the things which 
make the baby so interesting is that it changes and 
develops so rapidly. Almost every day sees some new 
accomplishment. 

In many ways the time of infancy is a critical time in 
the life of a human being. Indeed, the quality of health 
in later life is quite dependent upon the care given during 
this time. The baby is more delicate than the older 
child. It must be cared for in ways favorable to its 
health, and it must be protected from disease. 

Care of the baby. — Improvement in infant care has 
come about with increasing knowledge regarding food and 
its relation to growth. Mothers are urged to nurse their 
babies if possible. Babies are fed with small quantities 
of fruit juices or vegetable juices as soon as they are put 
upon a diet other than mother’s milk. The child early 
cultivates a taste for vegetables and whole-grain cereals. 

Our scientific knowledge in regard to the value of 
sunlight and fresh air also influences the care of babies. 
We put them to sleep in airy, sunny rooms, or on out¬ 
door porches. We let them stretch and play in the sun 



142 COMMUNITY HEALTH 

with very little clothing when the weather is warm and 
there is suitable opportunity. Ordinary window glass, 
as you know, keeps out the ultra-violet rays of the sun. 


THE BABY SLEEPS IN THE FRESH AIR 













































































INFANT WELFARE 


I 43 


Direct sunlight, or sunlight through special kinds of 
glass, aids the growth of the child. Sunlight and proper 
food prevent rickets, that disease of childhood in which 
the bones do not develop properly. Cod liver oil is 
sometimes called “ bottled sunlight ” because it contains 
Vitamin D and is, therefore, a means of preventing 
rickets. 

With our present knowledge of bacteria and bacterial 
cleanliness a new era in baby care began. Everything 
used in caring for the baby is kept as clean as possible. 
One reason why the mother nurses the infant during the 
first few months is that mother’s milk is safer than cow’s 
milk. The latter, as you know, must come from some 
distance and be handled by several people. Mother’s 
milk is also better because its composition is naturally 
suited to the needs of the baby, whereas cow’s milk 
must be modified. Mother’s milk has more sugar but 
less mineral matter and less protein than cow’s milk. 
It is more easily digested. If the baby must be bottle- 
fed, the best quality of milk should be used. Under 
what conditions should milk be produced to be safe for 
babies? 

Perhaps one of the most important items in scientific 
infant care is the attention given to routine. The baby 
sleeps at certain appointed times, he is fed regularly, he 
is bathed and dressed in the prescribed way. He is not 
wakened from sleep to entertain visitors. His food does 
not vary from that prescribed for him. 

The wise mother of today does not feed her child 


144 


COMMUNITY HEALTH 


candy, cake, ice cream, or any food outside the simple 
diet ordered by the doctor. Babies and young children 
do not cry for sweets unless they are taught to like them. 
They are satisfied with simple foods and with a small 
variety. Children who are brought up carefully on such 
foods as milk, fruits, vegetables, whole-grain cereals, 
bread and butter, have the best chance of becoming 
strong, with hard bones, firm muscles, and beautiful 
teeth. The child who eats sweets is likely to be fussy 
about other foods, and as a result he does not have the 
materials which are needed to build bone, muscle, and 
teeth. 

Dental hygiene. — The diet of the child up to six years 
of age largely determines the quality of the second teeth, 
which are being formed deep in the jaws behind the 
first teeth. Unless the diet of early childhood is rich in 
milk, leafy vegetables, and whole-grain foods, the body 
will not secure the calcium and other substances which 
are needed to build strong teeth. Hard foods, which 
necessitate vigorous chewing, are also important, be¬ 
cause they give exercise to the jaws and help them to 
develop naturally. Continual thumb-sucking, or the use 
of a pacifier, is likely to deform the upper jaw so that it 
causes a homely arrangement of the teeth. Sometimes 
stiff cardboard cuffs are put around a baby’s elbows so 
that he cannot get his hands up to his mouth. It is 
well worth while for children’s first teeth to receive 
dental attention. One of the most important services 
the dentist can ever render is to mend imperfections in 


INFANT WELFARE 


145 


the enamel of teeth as soon as possible after they are cut. 

Community responsibility. — Thus far we have con¬ 
sidered only the responsibility of individuals in the 
problem of infant care. The community has responsi¬ 
bilities too. 

First of all, it must provide conditions which are 
conducive to health and growth and which will protect 
babies from disease. Many of these problems related 
to healthful conditions for children have been discussed 
in earlier chapters. What is the relation of milk control 
to infant welfare? Is a pure water supply important 
for children? How are housing regulations related to 
infant health? What do parks and playgrounds con¬ 
tribute to the health of little children? How does 
communicable-disease control affect the child? 

A second duty of the community is to supply informa¬ 
tion about the proper care of babies and small children. 
There are many excellent books on this subject, and new 
information is constantly appearing from doctors and 
research workers. Sometimes people are puzzled to 
know which is correct information and which is mis¬ 
information. City and State Health Departments offer 
advice in regard to child care and recommend sources 
of information which are sound. Seek advice only from 
such reliable sources as your family physician, your 
nurse, your Board of Health, or your State Department 
of Health. 

A third way in which the community promotes infant 
welfare is through actual service to mothers and babies. 


146 


COMMUNITY HEALTH 



HOME HYGIENE CLASSES TEACH THE CARE OF THE BABY 

Of course, people who can afford to have their own 
doctors and nurses prefer to do so, but some people can¬ 
not afford such service. If there is a baby clinic in your 
city you will be interested to find out what service it 
gives. What nursing service is offered in your com¬ 
munity through the Board of Health or through private 
nursing organizations? How are these services paid for? 

You can easily see that it is to the advantage of the 
community to spend money on infant welfare. The 
most valuable possession of a community is its children. 





















INFANT WELFARE 


147 


They are the coming generation, and in providing for 
their health and vigor we provide for the future. 
Furthermore, the time of infancy is the most precious 
time from the standpoint of health. The quality of the 
care given during babyhood affects the health of later 
years. One may get a poor start or a good one. It is 
our responsibility, both as individuals in the home and 
as citizens in the community, to give the best possible 
care to these little tots who look to us for a proper start 
in life. 

Questions and Projects 

1. What health habits have been brought to your attention in 

the study of infant care? 

2. In what ways can boys and girls of your age aid in the care 

of younger brothers and sisters? 

3. Make a set of health rules for the care of babies, including 

those which have been mentioned in this chapter and any 
others upon which the class can agree. 

4. Arrange for different groups in the class to study and report 

upon the community activities for infant and child welfare. 
It may be desirable for a small committee to visit a baby 
clinic or the Health Department or some other place 
where baby-hygiene work is being carried on. 

5. Write to your State Health Department for pamphlets on 

infant and child welfare. Write for similar pamphlets 
to the Bureau of Education in Washington. 


XII 


THE HEALTH DEPARTMENT 

Who is your Health Officer? 

Do you know any one connected with the Health Department? 

What things have you known your Health Department to do? 

Do you know how the Health Department is organized? 

How many duties of the Health Department can you name? 

Why is it important for your city to have a good Health De¬ 
partment? 

The work of Health Departments in the United States 
saves literally thousands of lives every year. They make 
our towns, counties, and cities healthier and happier 
places in which to live. As young citizens you want to 
know what to expect from your Health Department, 
and as you look forward to voting citizenship you want 
to know what is the citizen’s obligation in securing and 
supporting a good county or city health organization. 

Organization. — The Health Department is a branch 
o{ the town, county, or city government. The organiza¬ 
tion is not always the same, but most commonly there 
are a Board of Health and a Health Officer or Executive 
Agent. The members of the Board of Health may be 
elected by the people or appointed by the mayor. Per¬ 
haps the best way of securing a good Health Officer is to 
have him appointed by the Board of Health. Sometimes, 
however, he is appointed by the mayor or by the town 
or county officials. 


148 


THE HEALTH DEPARTMENT 


149 


The Board of Health decides the policy of the depart¬ 
ment, but the task of doing, supervising, and directing 
the work rests with the Health Officer. He is the admin¬ 
istrator or executive officer for the Board. Let us con¬ 
sider what are the powers and duties of a local Health 
Department. 

Powers of the Health Department. — It is an accepted 
principle of government that nothing shall be allowed to 
endanger the health of the people if it can be prevented. 
As you know, the property and the rights of every indi¬ 
vidual are protected by the law. If a person attempts 
to do anything which endangers the health of other 
people the government has the right and the obligation 
to stop him. 

Let us see just what this means. If a man owned a 
piece of land beside a pond, would he not have the right 
to use it for any purpose he chose? Yes, unless the way 
in which he used it caused injury to other people. If the 
pond were being used as a water supply for the city, 
he could be prevented from throwing rubbish, dirt, 
or poisonous substances into the water or along the 
shore. 

Such a condition injurious to health is called a nuisance , 
and the Health Department would do away with it. A 
nuisance is anything that interferes with the health and 
comfort of people. Keeping pigs on a farm is not a 
nuisance, but keeping pigs in a city is a nuisance if dis¬ 
agreeable odors come from the pigpen and annoy the 
neighbors. 


COMMUNITY HEALTH 


I 5 ° 

The Health Department has the task of protecting the 
public from health dangers which may be caused by 
any person. It also protects the public from health 
dangers for which no one person is to be blamed. In 
those sections of the country where malaria is present, 
for example, proper sanitation demands that swamps 
shall be drained and that standing water shall be elimi¬ 
nated in order to prevent the breeding of mosquitoes. In 
some instances the Health Department enforces sani¬ 
tary rules and regulations; in other instances it acts to 
protect the health of the public when there are no writ¬ 
ten regulations. 

You have already learned something about the dif¬ 
ferent health activities which are carried on in the 
community. We shall study in this chapter the organi¬ 
zation of the Health Department for carrying out these 
activities. 

The work of Health Departments in different cities 
may vary somewhat. The organization of a large 
Health Department will naturally differ from that of a 
small department. The health activities in your com¬ 
munity will be most interesting to you, and you will do 
well to keep them in mind in your study and discussion 
of this chapter. 

A chart of a typical large city Health Department 
has been included here in order that you may see the 
number of its different activities and divisions. It will 
be simplest for us if we consider at this point the work of 
each division. 


THE HEALTH DEPARTMENT 


151 



W) Board of HealtK Qf 


Division of Communicable Diseases. — One of the 

most important duties of a Health Department is to 
prevent epidemics. For example, when a case of com- 






















152 


COMMUNITY HEALTH 


municable disease appears the Health Department im¬ 
mediately takes every possible step to prevent its spread. 
The important part of this task is to isolate the per¬ 
son who is ill and to quarantine the people who have 
been exposed to the disease and may come down with it 
later. The number of days after exposure before a 
person becomes ill with any particular disease is known, 
and quarantine will keep the exposed person away from 
other people until he comes down with the disease him¬ 
self or until it is certain that he is not going to have it. 
The time between the day when a person is exposed to a 
catching disease and the day when he becomes ill is 
called the incubation period. 

The chart shown here illustrates how a Health De¬ 
partment prevented an outbreak of measles. You can 


Controlling An Outbreak of Measles 


OM TRAIH-APR1L I 









THE HEALTH DEPARTMENT 


153 


see from the chart just what the Health Department 
did. First, a card was put up on the house so that 
other children would not come in to see Dorothy while 
she w’as sick. Then the Health Department found out 
what other children had played with Dorothy at the time 
she was coming down with measles. The initials of these 
children are shown on the chart. E. C., A. G., and D. G. 
had already had measles and could not catch them again. 
The other children were quarantined. F. J. and A. J. came 
down with measles in two weeks, but since they were in 
quarantine no one caught the disease from them. M. T., 
R. B., and F. A. did not come down with the disease 
and, after the incubation period had passed, they were 
released from quarantine. 

It used to be the custom of Health Departments to 
fumigate houses after all communicable diseases. Fumi¬ 
gation is a process of liberating certain gases in a house 
or building. This was done as an attempt to kill germs. 
The most common methods of fumigating were to burn 
sulphur or to heat formalin. It has been found that 
fumigation does not do much good, however. Health 
Officers now regard it as much more important to dis¬ 
infect everything which the patient has touched than to 
fumigate the house after the disease is over. We still 
fumigate to kill rats or insects which may be carriers of 
disease. 

You have learned that diseases like smallpox and 
diphtheria are controlled through immunization. This 
is an important part of communicable-disease control. 


i54 


COMMUNITY HEALTH 


Division of Hospitals. — A large city must have a 
Communicable or Contagious Disease Hospital. It 
frequently happens that a person cannot be cared for 
properly in his home. Often the home conditions are 
such that the disease would be almost sure to spread 
unless the patient is carried to a hospital. In order to 
safeguard the health of all the people in the city, there¬ 
fore, the Health Department provides a special hospital 
and brings these patients to it. There is likely to be a 
Tuberculosis Hospital, too, and there may be other 
hospitals under the supervision of this division. 

Division of Laboratories. — The laboratory of a Health 
Department does many interesting things. Here we 
find people specially trained and skilled in chemistry and 
bacteriology. Their work is related to that of many of 
the other divisions of the Health Department. 

One of the most remarkable things which the lab¬ 
oratory does is to help physicians in the diagnosis of 
communicable disease. The various tests made are too 
difficult to describe here, but you will want to know that 
the laboratory helps physicians to determine the pres¬ 
ence of diphtheria, typhoid fever, tuberculosis, menin¬ 
gitis, malaria, hookworm, and several other diseases. 
These laboratory tests discover signs of the germ in the 
discharges from the body of the patient. 

Here is a story which shows how a public health lab¬ 
oratory helped to prevent an epidemic by discovering 
the person who, as a “ carrier,” was spreading typhoid 
fever although she herself was not sick. In a summer 


THE HEALTH DEPARTMENT 


155 



A PUBLIC-HEALTH LABORATORY IS EQUIPPED FOR 
CHEMICAL AND BACTERIOLOGICAL WORK 

resort on the Atlantic coast, a few years ago, a case of 
typhoid fever appeared in one of the hotels. A few days 
later another case appeared. Such diseases are reported 
to the Health Department, and the Health Officer 
immediately started an investigation. He found that 
the people with typhoid fever had lived at the hotel for 
a month; thus he knew that they had picked up the 
germs of the disease after they had come to the sum¬ 
mer resort. He made a careful study, therefore, to see 
where the germs could have come from. 

He found that the drinking water was safe and that 
the milk which the hotel used was of excellent quality. 
Inquiry showed that none of the people in the hotel had 



COMMUNITY HEALTH 


156 

had typhoid fever recently. Bacteriological tests of body 
discharges showed that one of the cooks was a “carrier” 
of typhoid fever. She had had the disease two years 
before and had apparently recovered from it; but all 
the germs had not left her body. 

If this summer resort had not had a good Health 
Officer and a good laboratory, no one would have found 
out where the disease came from, and an epidemic might 
have resulted. As it was, the cook stopped work and 
received treatment until she was no longer a carrier. No 
one else caught the disease. 

The laboratory also keeps a check of the quality of 
the water supply, examining the water chemically and 
bacteriologically at regular intervals for signs of pollu¬ 
tion. If the water comes from a lake or reservoir which 
contains microscopic green plants, the laboratory exam¬ 
ines the water regularly for their presence. If they 
begin to increase in number, copper sulphate is added 
to the water in order to kill the algae before disagree¬ 
able tastes and odors are developed. 

The laboratory also tests samples of milk to make 
sure that it is clean and that it has not been watered 
or skimmed. Other food substances are tested in the 
laboratory to see whether they are adulterated. Sam¬ 
ples of alcoholic beverages which have been found by 
the police are examined to find how much alcohol they 
contain. Frequently it is discovered that these liquors 
which have been sold unlawfully contain wood alcohol 
or some other substance which is deadly poison. 


THE HEALTH DEPARTMENT 


157 

Is it not wonderful for the chemist to be able to take 
apart a substance like milk or other food, and for the 
bacteriologist to learn what bacteria are in a substance 
and how many of these plants are present? If your 
Health Department has a laboratory, it may be pos¬ 
sible for you to visit it and see the various materials 
which are used in making these interesting tests. 

Division of Food. — This division does the work of 
controlling food supplies. Restaurants and food estab¬ 
lishments, like bakeries and delicatessens, are inspected 
to see that they are sanitary. Most cities require that 
people who serve the food shall have a physical exam¬ 
ination or present a doctor’s certificate showing that 
they are free from communicable disease. 

Inspectors visit dairies and the establishments of 
milk dealers. They go to the stores to inspect ice cream 
and other foods. They collect samples of raw oysters, 
vinegar, butter, patent medicines, and beverages contain¬ 
ing alcohol. These are brought to the laboratory for 
examination. Cold-storage warehouses and slaughter¬ 
houses are inspected. 

Division of Sanitation. — Here is a large division with 
many interesting functions. Sanitary engineers are in 
charge of the purification of the water supply and the 
problems of waste disposal for sewage, garbage, and 
rubbish. They may have charge of mosquito-control 
work or they may be engaged in getting rid of smoke 
and dust. 

In this division we also find many inspectors who go 


COMMUNITY HEALTH 


158 

about the city to see that sanitary conditions are main¬ 
tained. They inspect the sanitation of factories, swim¬ 
ming pools, beaches, and houses. This division prevents 
sanitary nuisances. It controls the air conditions in 
public buildings. 

Division of Child Welfare. — This division of the 
Health Department gives advice to the general public 
concerning the care and rearing of children. Well-Baby 
Clinics and Clinics for Pre-School Children are often 
organized. Day nurseries, where children are cared for 
during the day while the mother is at work, are super¬ 
vised by this division. If the medical work in the schools 
is under the Health Department, that too is a part of 
the work of this division. 

Division of Nursing. — The largest single group of 
workers in most Health Departments is the group of 
public-health nurses. Public-health nursing is a new pro¬ 
fession, but already the nurse has become one of the most 
important public-health workers. She is not employed 
to take care of people who are sick, but rather to teach 
people how to care for others who are ill, and how to 
keep well by following the rules of health. 

The public-health nurses of the Health Department 
are often divided into different groups — infant-welfare 
nurses, tuberculosis nurses, communicable-disease nurses, 
and school nurses. Some Health Departments com¬ 
bine all of the nursing activities and give to each 
public-health nurse a small district which she serves in 
all of these different respects, carrying her health 


THE HEALTH DEPARTMENT 


159 



Courtesy of the Milbank Memorial Fund 


THE PUBLIC-HEALTH NURSE IS A WELCOME VISITOR 

message into all of the homes where she can be of 
assistance. 

The founder of the great profession of nursing was 
Florence Nightingale. She was an English woman who 
became famous by developing nursing care for soldiers 
during the Crimean War in 1854 and 1855. She actually 
saved the lives of thousands of men in this war by the 
good nursing care which she was able to secure for them. 
After the war she did much to aid in the training of 
nurses to be messengers of health as well as aids in the 
• cure of disease. The important place of the public-health 
nurse in the Health Department of today is a great 
tribute to the work and vision of Florence Nightingale. 





160 COMMUNITY HEALTH 

Division of Vital Statistics. — In this division the 
health bookkeeping of the city is done. A record is 
kept of the births and deaths and the communicable 
diseases. Birth rates and death rates are determined. 
From this division we learn the state of health of the 
city, just as we learn from a physician the state of health 
of an individual. The figures which are prepared make 
it possible to compare the healthfulness of our city with 
that of others. 

Division of Publications and Popular Health Instruc¬ 
tion. — One of the privileges of the Health Department 
is to keep the people of the city informed on matters of 
health through newspapers, special bulletins, lectures, 
moving pictures, and exhibits. This work is done under 
a special division only in large cities. 

The small town or city. — It has already been indi¬ 
cated that the organization and activities of all city 
Health Departments are not exactly alike. The descrip¬ 
tion of the different divisions given above, however, will 
furnish a good idea of the general plan of work in the 
average city. In small cities and towns the work of the 
Health Department is not so extensive as to require all 
these different divisions or a large group of public-health 
workers. In fact, in many small towns the Health 
Officer works alone, or with one or two assistants, doing 
all the things which need to be done. 

Such varied tasks require the attention of a person 
who is specially trained, and who has time enough to 
do the things well. A Health Department will not run 


THE HEALTH DEPARTMENT 


161 




itself. In small towns it may be that a satisfactory 
piece of work can be done by a man who sells only part 
of his time to the Health Department. Sanitarians 
generally feel that, for any group of people of 20,000 or 
more, there should be a full-time Health Officer. Many 
smaller communities have trained Health Officers. 

Trained sanitarians. — Public health is a distinct 
profession and has its professional society, the American 
Public Health Association, just 
as physicians have the Amer¬ 
ican Medical Association and 
lawyers have the American Bar 
Association. There are many 
different kinds of sanitarians 
besides the Health Officer. 
There are the sanitary engi¬ 
neer, the bacteriologist, the 
statistician, the public-health 
nurse, and the epidemiologist. 

Years ago, people did not understand the importance 
of public health, and it was thought that almost any one 
could be a Health Officer. It has too often happened 
that whenever a new mayor took office in a city he dis¬ 
charged the Health Officer and gave the job to one of 
his friends, often to some one who had not been trained 
in that kind of work. What kind of man should we have 
for a Health Officer, and how should he be trained? 
Perhaps some of you would like to become Health 
Officers. 



1812 


SEAL OF THE AMERICAN 
PUBLIC HEALTH ASSOCIATION 


162 


COMMUNITY HEALTH 



Courtesy of the American Public Health Association 

DR. STEPHEN SMITH (1823-1922) 

First President of the American Public Health Association 






THE HEALTH DEPARTMENT 163 

As you look over the tasks and duties of the Health 
Department you may think that the Health Officer 
should be a sanitary engineer in order to handle the 
problems of sanitation; or you may think that he should 
be a physician because he needs to know about disease, 
but you remember that he does not treat sick people. 
When we are sick We want a well-trained physician with 
wide experience in treating diseases. We do not want our 
family physician to spend most of his time in a city 
Health Department and treat sick people as a side line. 
Neither do we want a Health Officer who spends most of 
his time treating sick people, and who gives only a few 
hours a week to the many problems of the Health Depart¬ 
ment. 

The Health Officer should be a good business man if he 
is to run a large department, spend a great deal of money 
for the city, and have different kinds of people working 
for him. He should be a good administrator. It is also 
important that he be a good bacteriologist and under¬ 
stand laboratory work. You will see that he needs to 
know something about law, because when people break 
the public-health laws it will be his duty to bring them 
into court. 

When you consider the varied activities of the Health 
Officer you understand why public health is a distinct 
profession, and why it is desirable to have a Health 
Officer who is specially trained or experienced in his 
work. No town would think of hiring a superintendent 
of schools who never had any experience with schools, 


164 


COMMUNITY HEALTH 


and yet many towns hire Health Officers who have had 
neither training nor experience. A man does not need 
to be an engineer, a lawyer, a doctor, and a bacteriolo¬ 
gist. One could scarcely take time to learn all these 
professions, but he does need special training and ex¬ 
perience in public health. Some men have gone directly 
into the study of public health from high school or 
college, and others have entered this field from one of 
the other professions. 

At some future time, when you have become voting 
citizens, it may depend upon you to see that the Health 
Department in your city is run by a well-qualified Health 
Officer. He should be chosen because of his ability, and 
not because he is the friend of some politician. 

Visit to the Health Department. — The Health De¬ 
partment in your city is doubtless doing many valuable 
things for your health. Do you know about its work? 
The Health Officer probably would be glad to have a 
student or a small committee from your class or from 
your school go to the Health Department, where he can 
tell you about his work. Remember that he is a busy 
man and cannot give you an unlimited amount of time; 
but he almost certainly will be willing to arrange some 
time when a committee from your school can see him. 
The committee may report to the class upon the work 
of the Health Department. 

Here are some questions you may like to have an¬ 
swered during your visit to the Health Department: 
What kinds of records about births, marriages, diseases, 


THE HEALTH DEPARTMENT 



PROFESSOR WILLIAM THOMPSON SEDGWICK (1855-1921) 
A Pioneer in the Training of Sanitarians 



i66 


COMMUNITY HEALTH 



A VISIT TO THE HEALTH DEPARTMENT 


and deaths does the Health Department keep? Does 
the Health Department have a laboratory, and what 
kinds of tests are made there? Does the Health Depart¬ 
ment have sanitary inspectors, and what do they do? 
Is the water supply purified? If so, how? What does 
the Health Department have to do with waste disposal? 
What does the Health Department do in controlling 
milk and other food supplies? How does the Health 
Department work with the School Department? How 
much money does the Health Department spend each 


















































THE HEALTH DEPARTMENT 


167 

year, and how much is this per capita? Are there things 
which the Health Department needs in order to do better 
work? 

State Health Department. — You have learned from 
the study of civics and government that most of our 
laws and regulations are made by the legislature of the 
state. Some things must be done for the state as a 
whole, and these are done by the state government. 

The state legislature creates the State Department 
of Health and determines the relationship between it 
and the local Health Departments. Some state Health 
Departments have considerable control over city and 
county Health Departments; others have very little. 

What are some of the things which the State Depart¬ 
ment of Health does? It keeps health records. It 
studies and helps to control communicable diseases. It 
may manufacture antitoxins and vaccines. It approves 
the sanitary engineering plans of towns and cities. It 
promotes health instruction. It runs tuberculosis hos¬ 
pitals and sanatoria. 

National government and public health. — The Con¬ 
stitution of the United States does not directly assign 
any public-health work to the national government. 
The Federal government does some health work, how¬ 
ever. The organization which does most is the United 
States Public Health Service, a part of the Treasury 
Department. You remember that the Secretary of the 
Treasury is a member of the President’s cabinet. 

The United States Public Health Service prevents 


i68 


COMMUNITY HEALTH 


diseases from coming into the country and helps to 
prevent the spread of disease from one state to another. 
It studies public-health problems and helps to demon¬ 
strate the value of public-health work by cooperating 
with the Health Departments in different states. 

Other branches of the Federal government do some 
public-health work, too. The Army and the Navy have 
their own medical and sanitary divisions. The Depart¬ 
ment of Labor has done much for the health of people in 
industry. The Department of Agriculture controls the 
shipment of foods and drugs in interstate commerce. The 
Bureau of Education in the Department of the Interior 
contributes to the health of school children. 

Private health agencies. — Probably some of the 
public-health work in your community is carried on by 
agencies other than the Health Department. Do you 
know some of these? The National Tuberculosis Asso¬ 
ciation is a large and useful organization which is sup¬ 
ported by the people of the country, mainly through the 
sale of Christmas seals. The object of this association is 
to stamp out tuberculosis and improve the health of the 
people. Perhaps there is a Public Health Association 
where you live, or perhaps the American Red Cross is 
doing health work. There may be a Public Health 
Nursing Association, or health centers, hospitals, and 
dispensaries. Discuss these in class and see what you 
can find out about the various private agencies which 
are helping to make your community more healthful 
and happy. 


THE HEALTH DEPARTMENT 


169 


Questions and Projects 

1. Can you now give better answers to the questions at the 

beginning of this chapter? 

2. What are the duties of a Health Department? 

3. How is a Health Department organized? 

4. What does the Health Department do to maintain sanita¬ 

tion? 

5. What does a public-health laboratory do? 

6. What must be done to control the food and water supplies? 

7. How are communicable diseases prevented? 

8. Why is food inspected? 

9. Why is milk examined? 

10. Why is the work of the Health Department more effective 

than it was before the time of Pasteur? 

11. What can you do for the public health of your community? 

12. Arrange for a committee to visit the Health Department and 

report to the class. 

13. Write to the local Health Department, the State Department 

of Health, and the United States Public Health Service to 
find out what health pamphlets they have for free distri¬ 
bution. Study the list and secure those publications 
which the class believes to be interesting and useful for 
class study. 

14. See what you can learn about the work and publications of 

private health agencies mentioned in this chapter. 


XIII 


SAFETY 

Why is accident prevention important? 

Is safety a community problem? 

What are the agencies which help to prevent accidents? 

What is the proper attitude toward safety and accident pre¬ 
vention? 

Is safety a health problem? 

It is half past five on a week day in the city — the time 
of day when traffic is at its height. Tired people are anx¬ 
ious to reach home and are impatient of delays. At a 
crowded corner a policeman holds back the automobiles 
while the pedestrians cross the street. They are nearly 
across, and the officer blows his whistle for traffic 
to move. One young woman, somewhat behind the 
others, slackens her pace as she turns back to look 
anxiously for her friend whom she has lost in the crowd. 
She catches her French heel between two stones of the 
poorly paved crossing and falls in front of an approach¬ 
ing car. The driver jams on his brakes and swerves his 
car quickly to the side, but he cannot avoid an accident. 
There are two broken ribs, a broken arm, and many 
painful days in the hospital. 

How is the blame distributed among those who were 
connected with the accident? For what things was the 
girl herself responsible? Was the policeman at fault at 

170 


SAFETY 


171 

any point? What neglect in street maintenance added 
to the chance of accident? Was the driver of the auto¬ 
mobile to blame? In considering any accident, we see 
the many problems which are involved in accident 
prevention. 

Sometimes we think that accidents are confined to 
great cities and to places where machines are at work. 
This is not so. There are almost as many accidents in 
homes as there are from automobiles. Safety has always 
been a problem. Boys and girls in pioneer days had to 
look out for wild animals, while you and I have to look 
out for automobiles and street cars. Wild animals 
seem much more dangerous, but they never killed as 
many boys and girls as does the automobile. 

Kinds of accidents. — There have always been ac¬ 
cidents among people of every nation in every age. 
Do you remember the Bible reference in the writings of 
Saint Paul (II Corinthians xi, 26)? He speaks of being 
“ in journeyings often, in perils of waters, in perils of 
robbers, in perils by mine own countrymen, in perils by 
the heathen, in perils in the city, in perils in the wilder¬ 
ness, in perils in the sea, in perils among false brethren.” 
To avoid dangers has always been one of man’s important 
problems. The kinds of accidents, and the steps to be 
taken in order to avoid them, change with living con¬ 
ditions, with the kinds of work which men do, and with 
the growth of city life. 

Is safety a health problem? Let us look at some actual 
figures regarding the number and kinds of accidents, 


172 


COMMUNITY HEALTH 


and then see what the community should do toward 
preventing them and what you and I can do as individuals. 

According to figures prepared by the National Safety 
Council, 90,000 deaths were caused by accidents in the 
United States in 1925. This was about twelve times the 
number of deaths from typhoid fever (7430), and nearly 
two hundred and fifty times the number of deaths from 
smallpox (361). Of course, it is true that we need not 
have had any smallpox at all (ten European countries 
were free from smallpox during that year); but the point 
is that accidents are much more important than most 
people realize. We think of smallpox and typhoid fever 
as being important health problems, as indeed they are. 
But see how many more deaths are caused by accidents! 

The following figures show the different kinds of acci¬ 
dents which caused the ninety thousand deaths. 


Public Accidents . 46,000 

Automobile. 22,000 

Railroad. 7,800 

Street Car. 1,800 

Drowning. 7,000 

Others. 7,400 

Home Accidents . 20,000 

Asphyxiation and suffocations. 4,000 

Burns. 3,800 

Falls. 5,400 

Poison. 1,000 

Others. 5,800 

Industrial Accidents . 24,000 

Total Accident Fatalities. 90,000 

















SAFETY 


173 


Of course there are many accidents which are not 
fatal. Here are some other facts for the year 1925 from 
the same source as the figures quoted above: 

The number of non-fatal automobile accidents 


was. 660,000 

The economic loss from street highway accidents 

was. $600,000,000 

The number of fatal accidents among children 

under fifteen years of age was. 20,700 

The number of lost-time accidents in industry 

was. 3,000,000 

The economic loss for industrial accidents in the 

United States was. $1,000,000,000 

The economic loss for automobile accidents 

was. $600,000,000 

The economic loss for fire accidents was. $550,000,000 

The economic loss from home accidents was. $850,000,000 

The total loss from industrial, fire, automobile, and 

home accidents was. $3,000,000,000 


Automobile accidents. — You will see that the greatest 
single cause of accidents in the above list is the auto¬ 
mobile. The number of deaths caused by the automobile 
is increasing rapidly each year because more and more 
automobiles are being used. It was not so very long ago, 
of course, that there were no automobiles. If we look at 
the causes of death in New York City we find that up 
to the year 1898 there were no automobile fatalities. 
In the year 1899 there was one death from an auto¬ 
mobile accident; in the year 1900 there were five; and 
in the year 1925 there were 1022. 











i 74 


COMMUNITY HEALTH 


The following table shows the kinds of fatal auto¬ 
mobile accidents as classified by the National Safety 


Council. 

Automobile vs. pedestrian. 15,000 

Automobile vs. automobile. 2,330 

Automobile vs. railroad. 1,400 

Automobile vs. street car. 600 

Automobile vs. fixed object. 1,200 

Non-collision. 1,270 

Others. 200 

Total Automobile Fatalities. 22,000 


A city government regulates traffic by its speed laws, 
its rulings in regard to one-way streets and one-way 
turns, its system of traffic signals, and its traffic police. 
Through the proper maintenance of streets and side¬ 
walks, the city removes those obstructions — such as 
broken pavings, unused car tracks, and roots of trees — 
which may cause needless accidents. 

No matter how much the city does, however, traffic 
conditions cannot be made foolproof. The behavior of 
each individual who is a part of the traffic has an effect 
upon the safety of that individual and of others. The 
city cannot protect you if you will not protect yourself. 

Here are some of the rules governing pedestrian 
traffic: Cross the street where there is a traffic officer or 
a flashing signal. Wait on the sidewalk until you have 
the signal to go; then cross the street, paying attention 
to the business of traffic rather than to conversation. 

When you wish to cross the street where there is no 











SAFETY 


175 



Courtesy of National Safety Council 

ACCIDENTS COST MONEY 


traffic officer or signal, take extra precautions. Re¬ 
member that drivers of automobiles are always on the 
lookout for people entering from side streets, and that 
these places are the best ones to choose for crossing. 
Look in both directions and wait on the sidewalk until 






COMMUNITY HEALTH 


176 

you have an opportunity to cross in safety. Walk across 
the street, keeping your eyes open for traffic. If you 
feel that you have to run in order to get across in time, 
you had better wait. 

There are many other considerations in this problem 
of traffic. How should one get off a street car? How 
should one get on a street car in a busy street? How 
do playing children add danger to traffic for themselves 
and for other people? What can you do to increase 
traffic safety for yourself and others? What is the re¬ 
sponsibility of automobile drivers for traffic safety? 

Fire accidents. — Accidents from fire arise in various 
ways. Some one said long ago that lire is a powerful 
servant but a cruel master. As a servant, it gives us 
comfort and provides power for manufacturing and for 
transportation. As a master, it destroys property and 
injures human lives. Every child must understand 
when very young that fire is no plaything; that matches, 
gas flames, and electricity are to be handled only by those 
old enough to control them. Unfortunately, even grown¬ 
up people are sometimes careless in the handling of fire, 
so that every year there is great loss of life and property. 
What fires have you known about, and what were the 
causes? 

The community, in fire control, makes a direct attack, 
as it does in traffic control. The Fire Department in 
your city protects you day and night for three hundred 
and sixty-five days a year. Fancy trying to provide for 
yourself such expensive equipment. What you could 


SAFETY 


177 




WHAT LESSON DO THESE PICTURES TEACH? 










COMMUNITY HEALTH 


178 

not do for yourself, your city government can do. Fire 
Departments are expensive, as indeed are Police Depart¬ 
ments, but should you like to live in a city without this 
constant protection? 

What is your part in fire control? First of all, you 
practice intelligent care in handling fire. You know 
what to do in case of fire and how to call the Fire De¬ 
partment. You help to keep little children from fire 
accidents. You take part in fire drills at school and 
notice fire exits when you are in public buildings. 

Accidents from falling. — Many accidents are due to 
falls. Were you ever injured by falling? How did it 
happen? What other kinds of falling accidents have 
you heard of? How could these accidents have been 
avoided? 

The community has some responsibility in regard to 
these accidents too. Streets and sidewalks must be 
kept in repair. In winter time snow must be removed 
and icy sidewalks covered with sand, ashes, or salt. 
Public buildings are required to maintain stairways in 
good condition, to provide handrails at stairways, and 
to avoid obstruction in corridors and passageways. 
How is the proper lighting of stairways and halls related 
to these accidents? What has a yearly clean-up cam¬ 
paign to do with the safety of back stairs and fire 
escapes? 

Other accidents. — There are many other sources of 
danger. There are accidents from electricity (fallen 
wires), from drowning, from firearms, from fireworks, at 


SAFETY 


179 


railroad crossings, and from machines in factories. 
Refer to the first table in this chapter and discuss these 
safety problems in class, trying to determine the re¬ 
sponsibility of individuals and the responsibility of the 
community in each case. 

Alcohol and accidents. — You already know that the 
use of alcohol increases the chance of accidents. A large 
number of automobile accidents occur because the 
drivers are under the influence of liquor. The enforce¬ 
ment of prohibition by the government is very directly 
related to accident prevention. 

Safety activities. — The National Safety Council has 
made the chart of community safety activities on page 180. 
Discuss the meaning of the different items in this chart 
and see which of these activities you know to be going on 
in your community. 

Safety responsibility. — If we happen to be in posi¬ 
tions where we are especially entrusted with the safety 
of other people, we are under great obligation to meet 
that trust worthily. What positions or occupations do 
you think of which carry obligations for the safety of 
other people? What responsibilities are common to 
every one? 

In safety, as in other things, let us conduct ourselves 
as intelligently as possible. The boy who does show-off 
tricks, such as “ hooking ” rides in traffic or dashing 
across the street in front of a rapidly moving car, is not 
smarter than other boys. As a matter of fact he is less 
intelligent than other boys in regard to that particular 


COMMUNITY SAFETY ACTIVITIES 


180 


COMMUNITY HEALTH 


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Traffic law enforcement Enforcement of safe prac- Building inspection State labor department 

Enforcement Police tices where required Fire inspection inspections 

Courts Health inspection 
































SAFETY 


181 


thing. It is foolish to risk one’s own body needlessly, and 
it is a serious matter needlessly to expose other people to 
danger. 

On the other hand, only the selfish person considers 
his own safety when something important is at stake. 



COULD YOU RESCUE A DROWNING PERSON? 


The civil engineer and his men risk their lives in the 
construction of great bridges and aqueducts. The 
locomotive engineer or the captain of a ship may sacrh 
fice himself in time of accident to save those entrusted to 
his care. The telephone operator dares the fire or the 
earthquake shock in order to spread the alarm. Mem¬ 
bers of the Police Department and the Fire Department 
are subject to constant risk. Scientists throughout the 



182 COMMUNITY HEALTH 



Courtesy of the National Safety Council 

ARE YOU RESPONSIBLE FOR SAFETY? 


ages have risked their lives in studying ways to overcome 
disease and add to the joy and safety of living. You 
and I are willing to sacrifice health or life itself when the 
cause is worthy. 

We often use the slogan, “ Safety first but that 




SAFETY 


183 

phrase does not . mean that safety should be one’s first 
consideration throughout life. “ Safety always ” is 
a good slogan; but we shall define safety as refraining 
from taking needless and foolish risks. The phrase, 
“ Choose your adventure,” has been used to express 
this idea. What does that mean to you? 

Problems and Projects 

1. If you have a safety council in the city, consult it for infor¬ 

mation in regard to the safety program in your city. 

2. Learn from the Police Department what it does in the 

interest of safety. 

3. Develop four-minute speeches on safety and give them 

throughout your building. 

4. Outline the safety problems of your school. Consult your 

principal in making up the list. 

5. Organize a Class Safety Council. 

6. Report to your Class Safety Council the things you do 

in the interest of safety. Here are some of the things 
which pupils have reported in other places: 

(a) I told a fireman of a broken fire escape. 

( b ) I warned my father to keep the garage door open 

when he starts the car. 

( c ) I take a kindergarten child to school every day. 

(d) I helped an old man across the street. 

7. Discuss community responsibility in relation to the follow¬ 

ing questions: 

(a) What do building regulations have to do with safety? 

(b) What responsibility has the Street Department for 

safety? 

(c) How is city lighting related to safety? 

id) What could a Safety Council do to promote safety? 


XIV 


THE CITY PROVIDES RECREATION 

Do modern play activities differ from those of ancient civiliza¬ 
tions? 

Has the development of cities made any difference in the play 
activities of boys and girls? 

What is the relation between recreation and health? 

Why is it worth while for a city to spend money on parks and 
playgrounds? 

Play has been an important factor in the happiness 
and progress of the human race from the very dawn of 
history to the present time. Long ago, in the time 
when Greece boasted the highest civilization in the world, 
the great philosopher Aristotle wrote: “ That we should 
be able to enjoy leisure honorably is of all things the 
principal. In all cities there are family meetings, clubs, 
sacrifices, and public entertainments to promote friend¬ 
ship; for a love of sociability is friendship itself; so 
that the end for which a state is established is that the 
inhabitants of it may live happily. . . . The political 
state is founded, not for the purpose of men’s merely 
living together, but for their living as men ought.” 

The part which play contributed in some of the early 
civilizations is told in a delightful way by Bowen and 
Mitchell in The Theory of Organized Play. “ Excava¬ 
tions in the ruins of ancient Egypt and Babylonia reveal 

184 


THE CITY PROVIDES RECREATION 185 

toys such as dolls, tops, rattles, and various other trinkets 
of pottery and metal, showing that the boys and girls 
of those remote civilizations had their play life. The 
Chinese, Koreans, Peruvians, Aztecs, and other ancient 
races have left traces of their play in the toys of children 
and in the drawings and crude sculptures that depict 
boating, hunting, and festival scenes.” 

In another book about play, prepared by the Play¬ 
ground and Recreation Association of America, we find 
other interesting items as to the history of play. “ Public 
festivals, dancing, and music were favorite forms of 
recreation with the Egyptians of early times. The 
ancient Hebrews had their celebrations when the har¬ 
vests were gathered in, and religious festivals were 
permeated with a spirit of joy finding expression in 
singing and dancing. 

“ The sports and athletic contests of the earlier Greeks, 
in which there was widespread participation, are acknowl¬ 
edged to have contributed in a large degree to the leader¬ 
ship of early Greece, not only in physical vigor but in the 
country’s intellectual, art, and cultural life.” 

Recreation in country and city. — Perhaps never 
before were play activities as much needed as they are 
today. A few generations ago most of our people lived 
in the country or in villages. At that time most people 
Y^ere engaged in occupations which required vigorous 
physical work. Each man had the opportunity to see 
the results of his own labor and to take a just pride in his 
accomplishment. 


186 


COMMUNITY HEALTH 


Today we have become a nation of city dwellers. 
Large numbers of people work at occupations which 
require no vigorous exercise. Under our factory system 
of manufacture, many people are deprived of the satis¬ 
faction which comes from seeing the results of one’s own 
work. Of course, we all get enjoyment from work if 
we enter into it whole-heartedly. Often we can make 
play of our work. But in any case opportunity for 
vigorous exercise, for self-expression, and for pleasure in 
personal accomplishment is to be found in the hours of 
play. 

Conditions for play have changed, too, with the change 
from country to city life. Listen to any group of grown¬ 
ups who were country-born and see how different were 
their activities from those of the city child today. In 
their childhood days the opportunities for outdoor 
play were so inviting that children could scarcely be 
kept indoors. They had no need to beg, “ Oh, tell 
us something to play! ” for they were busy from one 
year’s end to another with their own schemes and 
plans. 

How different is city life today! Woods, fields, and 
seashore are available to only a small group of children, 
or are available only on special occasions after a long 
trip on the street car or in an automobile. Many a child 
has only the city street and a small yard in which to 
play. As a result, he either plays under conditions which 
are unsatisfactory or even dangerous, or he scarcely 
plays at all. 



F*ssiiSBS **»£8K81 

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Community responsibility. — What can be done? 
Clearly, cities must provide opportunities for play. It 
is, of course, an expensive undertaking to set aside land 
for parks and playgrounds, to provide gymnasia and 
swimming pools, and to furnish equipment and leader¬ 
ship for the play program. We have come to believe, 
however, that money spent for recreation is money well 
invested. 

A community profits in many ways by spending 


TIIE CITY 


PROVIDES RECREATION 










COMMUNITY HEALTH 


money to provide opportunities for play. Joyous out¬ 
door activity is essential to health, and health is above 
money value. Playgrounds help to make law-abiding 
citizens. Perhaps the most important reason for furnish¬ 
ing opportunities for play is that play makes people 
happy. 

In providing recreation for the community, there 
should be a wide range of activities, in order that every 
individual may find the things which are attractive and 
satisfying. There should be opportunity for those things 
which are related to mental and spiritual refreshment, as 
well as those related to physical exercise and develop¬ 
ment of body. In one large city the recreation activities 
include team games, sports, gymnasium, class work, 
clubs, handicraft, hiking, gardening, social dancing, 
movies, concerts, lectures, dramatics, reading, photog¬ 
raphy, and collecting stamps. 

The Playground and Recreation Association of Amer¬ 
ica makes the following recommendations for a com¬ 
munity recreation program. A community which has 
a population of eight thousand or over should have a 
full-time director of recreation. The program of activi¬ 
ties should extend throughout the whole twelve months 
of the year. It is the responsibility of the community to 
maintain recreation service, and tax money should be 
used for its support. The emphasis should be upon 
helping people to a worthy use of leisure time. Although 
the recreation program begins with playgrounds for 
children, it should increase progressively until it includes 


THE CITY PROVIDES RECREATION 


other features to supply all ages and all kinds of people 
with vital interests. Every boy and girl has a right to 
learn a number of games for outdoor and indoor use. 
Boys and girls learn to sing so that they may sing at their 
work or play. All young people employed in industry 
should have an opportunity in free hours to enjoy 
companionship and social life. 

Every new school building should have a certain 
minimum amount of space for playgrounds. Nearly 
every new school building should have an auditorium, 
preferably on the ground floor, constructed so that it is 
suited for community uses. Every child under ten years 
of age living in a place with a population of eight thou¬ 
sand or over should be given opportunity to play upon a 
public playground within a quarter of a mile from his 
home. There should be sufficient area for boys to play 
baseball and football. There should be opportunity for 
boys and girls to swim in summer and, so far as possible, 
to coast and skate in winter. Every boy and girl should 
have the opportunity, either on his own home grounds or 
upon land provided by the community, to have a small 
garden. In new real-estate developments of five acres or 
more, not less than one-tenth of the space should be set 
aside for recreation purposes, just as a certain amount is 
set aside for trees. 

These recommendations suggest an ideal which few, 
if any, cities can reach immediately, but the recreation 
movement is spreading rapidly. In more than one hun¬ 
dred and forty cities at the present time there is a, 


COMMUNITY HEALTH 


190 



*i* a! 





Courtesy of the American Child Health Association 

PUBLIC PLAYGROUNDS 




























THE CITY PROVIDES RECREATION 


191 


Municipal Recreation Commission, usually consisting of 
five members appointed by the mayor of the city. The 
members of the Commission usually serve without pay, 
and are responsible for the planning of the community 
program. Under their direction is a recreation leader, 
or director, who gives full time to the actual directing of 
the work. He has such assistants as are necessary. 

Playgrounds. — Space for playgrounds is a difficult 
problem in large cities. Many cities regret their lack of 
foresight in planning play space, and it is important for 
small but growing cities to provide land for this purpose 
before it becomes too expensive. According to the 
standards of the Playground and Recreation Association 
of America, a community should provide an acre of play 
space for every four hundred children of elementary 
school age, and, if possible, for every two hundred. 

There are various ways in which the playground space 
is being supplemented. Sometimes back-yard fences are 
removed, so that several back yards are thrown together, 
giving an area which supplies an excellent playground 
once it is cleaned up and equipped. Certain streets in 
some cities are set aside for play activities — for coasting in 
winter or for roller skating and games in summer. Street 
showers in hot weather are a blessing in crowded districts 
where bathing beaches and swimming pools are out of 
reach. 

Good playground leadership is most important. It 
enables children to develop through games the spirit of 
cooperation, the ability for good team work, and the 


192 


COMMUNITY HEALTH 


poise which enables them either to lose or to win with 
good sportsmanship. , 

School playgrounds are an important part of the 
community play space. During the school year they 
furnish a place for activity at recess, at noontime, and 
before and after school. In summer they may be used 
as community playgrounds under supervision. So impor¬ 
tant is the school playground in the community that many 
states now require that plans of all new buildings shall be 
submitted to state authorities for approval, and no plan 
is approved which does not have adequate play space. 

Parks. — A large part of the play space in a com¬ 
munity is usually in the public parks or reservations. 

“ The practice of setting aside spaces for park purposes 
is of long standing. When the Spaniards founded Santa 
Fe in 1565, a square or plaza was set aside in the center of 
the town for a public square. These early town builders 
frequently reserved large areas of land in the vicinities of 
the town known as ‘ pueblos ’ or public lands. Many 
years later the English colonists on the Atlantic Coast 
followed the custom of setting aside spaces for town 
commons. This was especially true in New England, 
where the town common became a recognized institu¬ 
tion. William Penn, in 1682, in laying out the plan of 
Philadelphia, carefully reserved at regular intervals 
five public squares of about six acres each. Other city 
planners, such as General Oglethorpe, who laid out 
Savannah in 1733, and Brigham Young, who developed 
the plan for Salt Lake City, set aside squares and open 


THE CITY PROVIDES RECREATION 


193 



PARKS PROVIDE SPACE FOR PLAY 


spaces. With a possible exception of Savannah, these 
early examples of the setting aside of land for future use 
were forgotten in the century that saw the rise and ex¬ 
pansion of modern industry and commerce. However, 
in the decade from 1890 to 1900 there came a dawning 
appreciation of the need of open spaces in urban com¬ 
munities, and within recent years there has been a 
tremendous development in city, state, and national 
parks. The national park area of the United States in 
1924 comprised nineteen different properties, with a 
total area of approximately 7,234,908 acres. The 
development of state parks has also been very rapid, and 
in a number of states, as for example Connecticut, the 
recreation uses of the parks are noteworthy. . . . 




194 


COMMUNITY HEALTH 


“ The recreation park varies in size, but should prefer¬ 
ably contain from ioo to 250 acres. It is suggested that 
there should be one such park for every 40,000 people, 
tangent tp or near the city limits of such population.” * 

Private organizations and recreation. — Frequently 
private organizations, such as the Boy Scouts, Girl 
Scouts, Young Men’s Christian Association, and Young 
Women’s Christian Association, assist in giving to city 
people a recreation program which is equal or superior 
to that of their country cousins. There should be a 
close cooperation between these organizations and the 
directors of the community recreation program. There 
should also be generous support of these associations 
which add so much to the health and happiness of the 
people in the community. 

Commercial agencies. — Much of the recreation in the 
modern city is supplied by commercial agencies, such as 
moving-picture houses, theaters, and pleasure resorts of 
various kinds. Much of this is wholesome recreation, 
but some of it is harmful. Remember that the forms of 
recreation which are most valuable are those in which 
the person himself takes part, rather than those in which 
he is merely an onlooker. 

Individual responsibility. — What does your city offer? 
Are you profiting by the opportunities which are open 
to you? Do not forget that long hours spent in pl^fy 
out of doors will bring great returns to you in health, 
happiness, and success. The boy who wishes to develop 

* From a report of the Playground and Recreation Association of America. 


THE CITY PROVIDES RECREATION 


195 



WHAT ADVANTAGES HAS THIS FORM OF RECREATION? 






COMMUNITY HEALTH 


196 

into a stalwart man needs an average of two hours or 
more of vigorous exercise every day. The girl who 
wishes to grow up with an attractive figure and clear 
complexion needs the daily tonic of sunshine, exercise, 
and happy recreation. Take part in all the sports which 
interest you. As you grow into adult life, plan your 
days so that you may play several hours each week in the 
great out-of-doors. 

Remember that both children and grown-ups need 
room and opportunity for play. There can be no hard 
and fast rule for organizing the leisure-time life of a 
community. The important thing is that its organiza¬ 
tion shall be nonpartisan and democratic. It should 
take into account all the different community groups. 
The responsibility for the success of the recreation pro¬ 
gram in a community must be shared between the private 
citizens and the city. 

Problems and Projects 

1. What recreation facilities are provided in your city? By 

whom are they provided? 

2. Who has charge of the recreation facilities in your community? 

3. Observe some playground in your city. Write a brief report, 

listing its advantages. 

4. Make a list of all the various forms of outdoor recreation 

enjoyed by members of your class. 

5. Arrange for the members of your class to keep records of 

their recreation and exercise for a week. See how much 

time you have spent in vigorous outdoor activity. 

6. Make a list of the recreation facilities which every city 

should provide. 


XV 


SCHOOL HEALTH 

How important is health as a part of education? 

What are the health activities of a public school? 

How much money does your community spend on the schools? 

Who does health work in the public schools? 

Do you ever consider why you go to school? There 
would undoubtedly be a variety of answers to this ques¬ 
tion in your class. One might say that he goes to school 
because he likes to learn new and interesting things. Dur¬ 
ing your school days you have the opportunity to learn 
what the world is like, what the history of nations has 
been, who have been the great men and women of the 
past, and what they have thought or accomplished. You 
acquire knowledge and you develop skills which will 
stand you in good stead during later years. 

If you think only of the present, you may say that you 
are happier in going to school than you would be in 
doing anything else. School is a social center as well as 
a place for study and work. Your friendships and 
companionships are an important part of your school 
life. “ Be friendly.” “ Work hard and play hard.” 
“ Treat others as you would like to have them treat 
you.” These are three guides to the path of happiness 
in school or elsewhere. 


197 


COMMUNITY HEALTH 


198 

If you look ahead to the future, you may say that you 
go to school in order to fit yourself to make a good living. 
On the average, boys and girls who stay in school earn 
more money in later life than those who leave school 
early. From studies of actual earnings the National 
Education Association concludes that “ Every day spent 
in school pays the child nine dollars. The child that 
stays out of school to earn less than $9.00 a day is losing 
money, not making money/ 7 

It is quite obvious that school makes life more pleasant 
for you now, and that it enables you to prepare yourself 
for adult life. Through your knowledge of books, art, 
music, nature, and people, you increase your power of 
enjoyment. The various kinds of knowledge and skill 
which you acquire make you capable of doing more 
interesting work and earning more money. Your ac¬ 
quaintance with history and civics makes it possible for 
you to be a more intelligent and responsible citizen. 

Where does health come in? Surely health is not an 
end in itself. It is worth while because it gives you free¬ 
dom to pursue happiness and success without physical 
handicaps. Health increases your chances of reaching 
the goals toward which you strive. Learning to develop 
health and to maintain it is, therefore, one of the most 
important accomplishments of school life. 

School health activities. — Here, as in other health ac¬ 
tivities, there is a responsibility upon both the individual 
and the community. Those who have charge of the 
schools should provide proper health activities and 


SCHOOL HEALTH 


199 



GOING TO SCHOOL IS AS IMPORTANT AS GOING TO BUSINESS 


sanitary conditions. Your part is to help in maintaining 
the best possible conditions at school, and to regulate 
your own life in a healthful manner. 































200 


COMMUNITY HEALTH 


The various activities in the school health program 
may be divided into three general groups: (i) health 
protection; (2) correction of physical defects; and 
(3) promotion of vigorous health. 

Health protection. — These activities are chiefly the 
responsibility of the school authorities under the city 
government. It is their duty to protect pupils from 
health dangers at school, and to provide surroundings 
which are safe, from the standpoint of health as well as 
of safety. 

A school building should be properly located. The 
classrooms should be sunny and airy, the grounds well 
drained, and there should be freedom from dust, noise, 
and disagreeable factory odors. It is desirable to have 
schools situated on streets which do not have so much 
automobile traffic as to make accidents likely. 

Among the important items in the construction of the 
building are: protection from fire, adequate supply of 
good drinking water, a sufficient number of toilets and 
lavatories kept clean and light, a room for the doctor 
and nurse, a rest room for teachers, clean floors, and 
proper lighting for classrooms. Can you add other 
items to this list? 

As pupils you have no choice in the location and con¬ 
struction of the building, but you can do much to help 
in keeping it clean and healthful. You can aid in keep¬ 
ing the floors, corridors, lunch rooms, wash rooms, and 
toilets clean. You can see that the bubbler fountains 
are properly used. By appointing a thermometer inspec- 


SCHOOL HEALTH 


201 


tor in your classroom, you can help to regulate the 
temperature. 

You can also help with the proper adjustment of chairs 
and desks. Here is the test for proper seating: When 
you are sitting with your hips pushed away back in your 
chair, your feet should be flat on the floor and your 
knees bent at right angles. When your arms are placed 
on your desk as in a position to write, your desk should 
be at such a height that your shoulders are in a natural 
position. 

Another part of the health-protection activities is the 
control of communicable disease. The doctor, nurse, 
principal, and teacher play the leading roles here, but 
the cooperation of every pupil is needed. * Children who 
have measles, diphtheria, chickenpox, or a cold are 
required to stay away from other children until the 
doctor is sure that they can no longer give the disease 
to others. When a pupil returns to school after such an 
illness, it is his duty to report to the teacher, principal, or 
nurse before entering his classroom. 

In many classes, during the morning inspection for 
cleanliness, the teacher observes whether any pupil has 
red or inflamed eyes, running nose, or flushed cheeks. 
Many of the communicable diseases, as you very likely 
know, have early symptoms like those of common cold. 
Any pupils who show such symptoms should be sent to 
the doctor or nurse at once in order to find out what is 
wrong, and thus protect other pupils. 

It is the custom in many places for school doctors and 


202 


COMMUNITY HEALTH 


nurses to inspect all children after a vacation, to see 
whether any one has returned to school with a communi¬ 
cable disease. It is the duty of the doctor and nurse to 
decide when a sick pupil should be sent home, and to 
undertake whatever measures are necessary to check the 
spread of a disease at any time. 

You may be interested to know that it was because of 
the fight against communicable disease that doctors and 
nurses were first employed for work in the schools. 
Forty or fifty years ago there was nearly always an epi¬ 
demic of measles or some other communicable disease 
as soon as school opened. This has been avoided by the 
present-day system of medical inspection in schools. 
Before the days of the school doctor and nurse it was 
customary to close schools when an epidemic appeared. 
Now epidemics are controlled better by keeping the 
pupils in schools where they can be supervised very 
carefully. 

Your part in this communicable-disease program is to 
obey the doctor’s orders when you are ill, and to stay 
away from others when there is danger of your infecting 
them with a disease. 

Another important thing which you can do to help 
solve the problem of communicable-disease control, 
both for yourself and for the community, is to be im¬ 
munized against those diseases for which there is protec¬ 
tion. What are they? Could your class promote a 
campaign to interest every pupil in your school in being 
immunized? 


SCHOOL HEALTH 


203 


No man would think of running an automobile year 
after year without having it overhauled and the neces¬ 
sary repairs made. Of course the human body repairs 
itself to a large extent, but it needs to be examined occa¬ 
sionally for defects or difficulties which can usually be 
corrected if they are found in time. Growing boys and 
girls frequently have slight defects which hinder their 
growth and their progress in school. Many pupils have 
defective eyesight, sometimes without realizing it. If 
their eyes do not receive attention, headaches and other 
painful results are likely to follow. A boy whose heart 
is weak is better off to avoid vigorous play. Such 
examples show the need of physical examinations in 
school. 

The custom in most places is to give the pupil a 
thorough examination when he enters school, and every 
few years thereafter. If for any reason he needs an 
examination between these regular periods, he receives 
it. Thousands of adults now go to their physicians 
every year to be examined. In school the examination 
is sometimes made entirely by the doctor, and sometimes 
in part by the nurse or teacher. 

Correction of defects. — You can easily see that the 
health examination is of no value unless the defects 
found are corrected. Are you free from physical defects 
at the present time? With the aid of the hygiene 
teacher, home-room teacher, physical educator, or 
nurse, you can conduct a campaign to follow up the 
corrections of physical defects in your class. It would be 


204 


COMMUNITY HEALTH 



FORSYTH DENTAL INFIRMARY FOR CHILDREN 


embarrassing for each pupil to have his defects posted on 
the board, but the total number of defects may be listed 
and the corrections recorded as they are made. Can 
your class secure a rating of 100 per cent on the correc¬ 
tion of physical defects? 

Maintaining and promoting health. — This is the most 
important and interesting part of the school health 
program. It is also the part which belongs primarily to 
you. 

Principals and teachers plan the routine of the school 
so that the program will be healthful. Consideration is 
given to the length of the school day, suitable recesses, 
brief rest periods, and the school lunch. 

Most schools have a daily health inspection during the 












SCHOOL HEALTH 


20 5 


opening period or during a home-room period. Why is 
such an inspection valuable? Weighing and measuring 
at regular times enable you to watch your growth. How 
much have you gained in height and weight during the 
past year? Does this compare favorably with the gains 
made by other members of your class? 

Some schools have a midmorning lunch of milk and 
v crackers, an extremely helpful thing for many young 
people. Some need the extra feeding in order to make 
their desired growth; others find that refreshment at 
this time enables them to do better school work. Possibly 
you prefer fruit at the midmorning lunch period. 

Relaxation periods or stretching exercises done with 
windows open furnish another way of relieving the 
fatigue which comes with constant sitting. Your 
schedule may be so arranged that you are moving from 
one room to another frequently and thereby get your 
period of relaxation in a natural way. 

Physical education or physical activity. — What is the 
physical-education or physical-activity program in your 
school? Do you know what it is like for children in the 
lower grades? By whom is your physical-education 
program directed? What do you do in it and what do 
you like best about it? 

Of course a physical-activity program contributes to 
health, but health is not its sole and primary object. 
Physical education is a part of the general process of 
education and, like the rest of the educational process, 
seeks to enrich life in various ways. Through physical 


206 community health 

activity the body is trained to efficiency. Sports and 
games are more easily learned in youth, and they continue 
to furnish a source of enjoyment in adult life. Through 
games, you learn to play fair, to be a good sportsman, 
to be both a good winner and a good loser. Through 
your play activities you make friends and learn to get on 
happily with other people, and to compete with others 
without ill-will. Perhaps greatest of all is the joy which 
comes from the possession of a body which is physically 
fit and a mind refreshed by hours of happy recreation. 

Health education. — This includes the many activities 
which pupils undertake, with the aid and direction of 
teachers, principals, and supervisors, for their own 
health improvement. Every one is interested in his own 
health, of course. When you were a very small child you 
did not think of it as you do now. Then it simply 
meant growing, playing, running, and doing the things 
which all children enjoy. Now health means to you a 
condition in which your body and mind are at their best. 
It means a fine development into manhood or woman¬ 
hood. It promises a future with much happiness and 
success. 

If you were asked to point out the way to health, 
what would you think most important? Undoubtedly 
you would decide upon habits of living. Have you ever 
stopped to consider what is meant by a habit? Look up 
the word in the dictionary. What health practices can 
you honestly say you have established as habits? 

It is quite interesting to consider how habits are formed. 


SCHOOL HEALTH 


207 


Sometimes you set yourself definitely to do a certain 
thing and continue it regularly until it becomes a fixed 
habit so that you do it without thinking. Sometimes 
you start to do a thing merely by accident and continue 
the practice until it becomes a habit. For example, 
some particular word or phrase becomes popular, and in 
a short time you find that you are using it constantly. 
Wherever you live you are almost certain to find an 
adjective or phrase, sometimes of good English usage 
and sometimes of slang origin, which is used continuously. 
Its use has become a habit. 

Habits of living are established in the same general 
way. It is important to have the scientific facts in regard 
to health, but knowledge alone does not produce good 
habits. If you are well informed in matters of health, 
however, you are better able to choose those habits 
which you will deliberately seek to establish in your 
own life. Such habits are fixed by repeating them over 
and over again until it becomes easier and pleasanter to 
follow the habit than to do anything else. Bad habits 
which have become fixed accidentally or carelessly can 
be broken by a continued deliberate effort and by the 
substitution of a good "habit. The use of tobacco or 
alcohol is a serious habit which interferes with proper 
growth. 

You will find in general that, the older you grow, the 
more difficult it is to break old habits and form new ones. 
That is why it is so important to form the desired habits 
of living when you are young. One thing which you can 


208 


COMMUNITY HEALTH 



DAILY INSPECTION IS AN IMPORTANT PART OF THE HEALTH 
PROGRAM 


do for your younger brothers and sisters is to help in their 
development of proper health habits. Your example will 
be a more powerful influence than anything you can say. 

What activities are organized in your class to help 
each pupil to improve his habits of living? You have 
found in the Appendix some suggestions for interesting 

















SCHOOL HEALTH 


209 


projects. You and your teacher can think of many 
others. Remember that what you yourself do for your 
own health will always be more important than anything 
which can be done for you. Your health is affected, not 
by what you know, but by what you do. 

The School Department of the city of Cleveland has 
set up in its health outline a few commonly recognized 
principles of healthful living, in the form of “ The Ten 
Commandments of Health. ” 

1. Keep the body clean. 

2. Eat the right amount of wholesome food. 

3. Get enough sleep and rest. 

4. Keep the body erect. 

5. Play and exercise properly. 

6. Keep your school, home, and neighborhood as healthful as 

possible. 

7. Keep a healthy mind. 

8. Prevent accidents. 

9. Avoid communicable diseases. 

10. Know your own physical limitations and live within them. 

The citizen and the school health program. — In a 

few years you will cease to be a pupil of the public 
schools. Very likely you will have children of your own 
in school. It is important to have the schools under the 
direction of capable people. It is also important to 
supply enough money for the support of the schools so 
that the necessary health conditions may be maintained. 
Because of the close relationship of health to the whole 
development of the child, the school health program is 
an extremely vital part of the community responsibility. 


210 


COMMUNITY HEALTH 


Problems and Projects 

1. What could the Student Council do to promote health? 

2. Rate your present health standing by using the “Personal 

Health Scale for Junior High School Boys and Girls” given 
in the Appendix. 

3. What could a school newspaper do to promote the health 

program? 

4. Under the three headings of (1) health protection, (2) cor¬ 

rection of defects, and (3) promotion of vigorous health, 
list the activities which are carried on in your school. 

5. In what ways have you profited personally by the health pro¬ 

gram in your school? 

6. In what ways could health be promoted in your school by the 

use of competitions, bulletin boards, clubs, plays, assembly 
periods? 


XVI 


THE HEALTH OF THE WORKER 

What kind of work do you think you would prefer to do when 
you finish school? 

What are the things you like about this occupation? 

Is one occupation more healthful than another? 

What are the ten or twelve most common occupations in the 
community where you live? 

What are some of the rare or less common occupations? 

What factors should one consider in determining the healthful¬ 
ness of a job? 

Is it important to health that one should enjoy his work? 

To what extent can a man control his own health regardless of 
his occupation? 

What working conditions are there over which the worker has 
no control? 

What may the worker expect from the modern industry in the 
way of health service? 

What should we expect the government to do toward main¬ 
taining the health of the worker? 

Choosing an occupation. — Have you thought of the 
kind of work you are going to do when you leave school? 
Probably you have; but have you stopped to think of all 
of the different kinds of work from which it would be 
possible for you to choose? Have you taken the trouble 
to learn something about these occupations in order to 
see which one you would like best? This is an important 

choice — picking out an occupation. Suppose you were 

211 


212 


COMMUNITY HEALTH 



HAYING IN NEW ENGLAND 

(Reproduced from the Cyclopedia of American Agriculture, by courtesy of 
The Macmillan Company) 


to decide today what you would do every evening for the 
next ten years! You would want to be very sure that 
you selected something which you would enjoy. 

Young people do not always stop to think, when they 
pick out a job, that they are deciding what they are 
going to do forenoons and afternoons, every working 
day for several years. Of course one cannot always 
choose the particular occupation he likes best, but it is 
usually possible to choose among at least a few occupa¬ 
tions. Do you like work which takes you out of doors, 
or do you like to be indoors? Do you like machinery? 
Do you like gardening? Do you like to build things and 
plan things? You may like to find out what occupa- 





THE HEALTH OF THE WORKER 


A ROOM IN A TEXTILE MILL 

tions are thought most interesting by different members 
of the class. 

We find that when people learn to do a job well they 
usually like it. It sometimes happens that one does not 
like his job because he has not learned it thoroughly, 
and when he learns to do it well he enjoys it much 
more. Sometimes one chooses a job merely because it 
seems possible to make good money at it. But surely it 
would be foolish for one to agree to do something which 
he did not like, every forenoon and every afternoon, 
merely because it paid a little more money, if he could 
secure fair pay at something which he enjoyed much 


more. 




214 


COMMUNITY HEALTH 


One’s success in his work influences his advancement; 
and, since one is more likely to succeed in a job which he 
likes, that is another reason for picking out the job 
carefully. We are particularly interested in this class in 
deciding upon the importance of health in relation to this 
problem of occupation. How important is health in 
picking out a job, and how can one maintain vigorous 
health in the job which he picks out? 

The kinds of jobs available and their effect upon 
health differ in different parts of the world. The prob¬ 
lem of keeping well and making a living is different 
for the Eskimo than for the Cuban, no matter what his 
particular kind of work may be. In your study of 
geography you will find it interesting to consider the 
kinds of occupations in different countries and their 
effect upon the mode of living and the health of the 
people. In history, too, you will find this same interest¬ 
ing relationship. How, for example, did the occupations 
and habits of people in America one hundred years ago 
compare with our present occupations and habits? 

Work and health. — While it is true that different 
occupations may have an effect upon health, it is prob¬ 
able that the way one lives, the way he adapts himself to 
his job, and the way he takes care of his general health, 
are more important than the job itself. Suppose a man 
looked at his job in a factory, or in an office, or in a 
profession, in somewhat the same way that a college 
football player looks at the job of playing football when 
the season is on. 



PRIZE STOCK COMPETITION 


(Reproduced by permission, from Extension Bulletin 63 of the Agricultural 
Experiment Station of New Jersey) 


Perhaps a better example would be the athlete who is 
giving all his time to training. Let us take for example 
the American Olympic team. The Olympic Games are 
held every four years, and they include every type of 
athletic sport. Practically all of the nations send teams to 
compete in these games. Any amateur athlete— that is, 
any one who has not played for money — can “try out” 
for this team. After the team is chosen it must travel to 
the country where the games are being held. When the 
United States team is formed, for example, the group of 
men and women meet in New York and go on board the 
boat which is to take them to Europe. Life on a boat 
would not be good for an athlete if he merely loafed and 
ate all the food which his sea appetite would suggest. 
He chooses his food carefully, however; he secures the 
right amount of sleep and has vigorous exercise every 
day. When he is traveling by train he is again in a place 



2l6 


COMMUNITY HEALTH 



SKILL, COURAGE, AND PHYSICAL FITNESS ARE DEMANDED 
IN THIS OCCUPATION 

where it is difficult to continue his athletic training. 
Nevertheless he finds a chance to get out sometime dur¬ 
ing the day for his exercise. He sleeps and rests enough, 
and takes care of such other habits of living as are im¬ 
portant for athletic proficiency. 

In somewhat the same way the person who works in 
an office needs a schedule outside of working hours which 
will make it possible for him to keep fit. The health 
rules which we follow as pupils in school are equally 
essential for adult life and for maintaining working 
efficiency. 

The person who is doing hard muscular work needs to 
plan for relaxation. The one who is working a particular 




THE HEALTH OF THE WORKER 217 

set of muscles needs to plan exercise for the other muscle 
groups. The person who is doing mental work does not 
get so much exercise as the person who is doing muscular 
labor, unless he secures physical activity through sports 
and recreation. As a matter of fact, the failure to follow 
any of the basic rules of health — drinking enough water, 
eating vegetables, having a daily bowel movement, 
keeping the body clean inside and out, and getting the 
right amount of food —will more or less incapacitate a 
person for his job. 

Hours of labor. — One of the things about a job that 
have an effect upon health is the number of hours a 
person works per day or per week. Naturally the more 
work one is able to do, the more money he will make. It 
would at first seem that the more hours per day one 
worked, the more work he could do. This, however, is 
not true beyond a certain limit. In the first place, we 
must recognize that there are different kinds of jobs. A 
man can ride horseback longer than he can play football. 
Likewise a man could work longer as a teamster driving 
a span of horses and hauling logs than he could as an 
engineer driving the engine of an express train. 

The human body is a machine which uses up its energy 
by physical effort, but which has the peculiar power of 
getting rested during relaxation and sleep. It may get 
tired in six hours of working very rapidly, or it may take 
ten hours to become equally tired if it does a less 
strenuous kind of work. By experience we should be 
able to tell what the best number of hours per week 


2l8 


COMMUNITY HEALTH 


would be for each kind of job, allowing for the greatest 
amount of work without injuring the health of the 
worker. 

It has sometimes happened that people have worked 
too many hours a week. When the length of the week 
was reduced, the amount of work done was increased. 
For example, during the war, England made ammunition 
with the greatest possible speed. Many people worked 
seven days a week, but it was found after a time that they 
could do more work in a month by working six days a 
week than by working seven. 

In other cases shortening the hours of the working 
day increased the amount of work which a man was able 
to do. On one particular operation in ammunition facto¬ 
ries the number of hours of labor was reduced by about 
one-eighth (12 per cent), with the result that the amount 
of goods manufactured was increased by more than one- 
fifth (22 per cent). 

Fatigue. — The reason a man may actually do much 
less work if he stays at the job too many hours a day is 
that he gets too tired. Fatigue in industry is an impor¬ 
tant health problem, and there are a great many sides 
to it. 

We must first understand what is meant by normal or 
natural fatigue. Every one is properly tired at the end 
of the day when he has done a good day’s work with 
enough vigorous physical exercise. This is as it should 
be. The person is glad to go to bed and he sleeps soundly, 
waking up in the morning fully rested. If one becomes 


THE HEALTH OF THE WORKER 219 

too tired, however, he is not thoroughly rested by the 
night’s sleep, and he has what we call cumulative fatigue. 
This may increase so much through the week that it is 
not dispelled by the full day of rest on Sunday. If this 
happens the worker becomes more and more tired, and 
does less work each day. Fatigue also increases ac¬ 
cidents. 

Let us recognize, too, that there is mental fatigue as 
well as physical fatigue. One does not work too rapidly 
mentally, but one may work too long. When one works 
rapidly, one’s mind is thoroughly concentrated upon its 
task and does its best work. It is easier to work with 
good concentration than with poor concentration. 

In fact a series of interruptions, or a condition in 
which the mind jumps from one thing to another, is 
most difficult and tiring. The brain becomes tired after 
a time. You may have found that you can do your 
studies a great deal faster when your mind is fresh, and 
you are feeling well, than when you are tired or when 
your mind wanders from your studies. 

Mental fatigue is just as definite as muscle fatigue, 
and it takes longer for the mind to become rested than it 
does for the muscles. When one is tired physically, one 
feels like taking a long sleep, but when one is tired men¬ 
tally, without having had physical exercise, one may 
realize only that one is nervous and irritable, without 
understanding that one needs rest. It is often helpful 
for the person who is mentally tired to become physically 
tired also. 


220 


COMMUNITY HEALTH 


Another cause of fatigue is poor living conditions. By 
this we mean that the home is not comfortable and the 
worker does not get the rest he should while he is in 
the house. He gets poor food, little sleep, and no real 
contentment. 

A third cause of fatigue is poor transportation between 
one’s home and one’s place of business. One may have 
a long ride on the trolley cars or trains, which is tiring 
in itself, and which adds to the working day. 

In the fourth place, there may be unnecessary fatigue 
because of the conditions of work. This happens if one 
works in a room where it is much too hot or where the 
lighting is bad; or if one sits in a chair which is not the 
right height; or if one has to work in an awkward posi¬ 
tion. 

A fifth cause of fatigue may be the way in which the 
work is done. On some jobs it has been found that people 
will do more work by having short rest periods than if 
they work continuously. We may illustrate this with a 
true story of two groups of men who competed to see 
which group could dig the longer trench in a given length 
of time. One man had his team work continuously as 
hard as they could for the whole period. The other had 
his team work hard for a few minutes and then rest 
completely for a few minutes. The latter group won. 

Another interesting example was the case of a man 
who found it possible to do three times as much work by 
allowing himself brief rest periods. He was loading 
metal on freight cars and he found he could do much more 


THE HEALTH OF THE WORKER 


221 


on a program of work — rest — work — rest, than on a 
program of work — work — work. 



OUTDOOR SPORT FOR THE INDOOR WORKER 



222 


COMMUNITY HEALTH 


It is easy to see that the length of the working day, 
the kind of work, rest periods, the suitability of one’s 
food, sleep, rest, and daily habits are related to the 
fatigue of the worker, to his accomplishment, and to 
his health. 

Dangerous trades. — While the conditions mentioned 
above are present in all kinds of work, there are, of 
course, certain jobs which are more dangerous than 
others. For example, one would say that being an 
aviator is dangerous, because it has not yet become 
possible to handle airships without accidents. 

-Working with lead or lead paint is dangerous, because 
when lead is taken into the body it acts as a poison. A 
worker may get it on his hands and swallow some 
while eating his lunch unless he has washed his hands 
properly. One of the results of lead poisoning is a 
stomach trouble which is commonly called “ painters’ 
colic.” Another result is the loss of strength in the 
wrist causing “ wrist drop.” Lead poisoning is a partic¬ 
ularly dangerous thing because the effects of lead poison¬ 
ing are likely to appear in the worker’s children. Many 
of the children of parents who have lead poisoning are 
not well and strong when they are born. 

There are some other substances which are poisonous, 
such as arsenic, benzene, mercury, and wood alcohol. 
Carbon monoxide gas is a poison. You have probably 
read of men who have been killed from this poison by 
starting an automobile in the garage with the garage 
door closed. Carbon monoxide is produced when 


THE HEALTH OF THE WORKER 223 

substances are not thoroughly or completely burned. 
There is enough carbon monoxide in the exhaust gases of 
an automobile to cause death if these gases are allowed to 
accumulate in a closed garage. Whenever men are where 
poisonous substances are used in a process of manufac¬ 
ture, they must take such precautions as will prevent 
them from being poisoned. 

In some occupations there is considerable dust, but 
proper habits of cleanliness will take care of the skin. 
It is somewhat more difficult to take care of the lungs. 
There is more tuberculosis among stonecutters, for 
example, than among farmers. This is because of the 
sharp, irritating stone dust. Mining coal is a fairly 
dusty operation, but coal dust does not seem to irritate 
the lungs very much. There is no more tuberculosis 
among coal miners than among people generally. 

Tuberculosis is not produced by dust alone. The 
person who does not take good care of himself, and get 
enough rest, sleep, fresh air, and good food, is more 
likely to develop the disease. Alcohol increases the sus¬ 
ceptibility of people to tuberculosis. 

Going to work too young. — In general we see that the 
health and happiness of people are rather directly con¬ 
nected with the kind of job they pick out. It is partic¬ 
ularly important for boys and girls not to go to work too 
young. Dr. Collis has shown that boys who used to go 
into the textile mills in England at the age of twelve did 
not grow as much between the ages of twelve and eighteen 
as other boys. Do not conclude, however, that boys and 


224 


COMMUNITY HEALTH 


girls must not do any work at all. All young people 
ought to help at homeland many kinds of work are just 
as healthful as playing games for the same length of 
time would be. 

At what age is a boy allowed to go to work in the state 
where you live? What is the value of requiring a physical 
examination and a working certificate before a boy or 
girl is allowed to take a job? 

Healthful working conditions. — We know that our 
health lies in our own hands. On the whole, probably 
the way we live has more to do with our health than the 
places where we work. Nevertheless, the conditions 
under which a man works are important. If one of us 
were to take a position in a factory, he would want to 
select one where the working conditions are healthful — 
not one where they are unhealthful. What are the con¬ 
ditions you would want? 

If you took a job inside, you would want the factory 
to have good conditions of lighting and ventilation, 
would you not? You would expect safety to be secured 
as much as possible by putting guards over dangerous 
machines and teaching the workmen to avoid possible 
injuries. Poisonous substances would be handled in 
such a way that they would not endanger the health of 
the worker. If there is a restaurant at the factory, you 
would expect that the food would be clean and the 
restaurant well managed; that the people who handle 
food would be well; and that no person who had a 
communicable disease would be allowed to cook or serve 


THE HEALTH OF THE WORKER 


225 



AN ATTRACTIVE CAFETERIA 

the food. You would expect reasonable standards of 
cleanliness in the factory according to the kind of work 
which is being done. 

Yet many factories go even further. The number of 
hours in the working day is adjusted to the kind of work 
done. Fatigue is studied, and ways are found to reduce 
it. Machines and chairs are adjusted so that workers 
may stand or sit in a proper, easy posture. Medical 
service is provided so that the worker may have a 
physical examination and the advice of a competent 
physician. Great care is taken to prevent the spread 
of any communicable disease in the factory. In some 






226 


COMMUNITY HEALTH 



A WELL-BUILT FACTORY 

places industrial nurses visit the worker who is sick. 
Care is often taken to improve transportation to and from 
the factory so that the worker will not be unnecessarily 
tired in traveling to and from work. Dental service is 
frequently provided. Suitable opportunities for recreation 
help the worker to maintain and improve his health. 

These activities to keep workers well are quite natural. 
In the country, when a farmer is choosing a man to work 
for him he considers the man’s health as well as his 
ability. Having once hired him and become acquainted 
with him, the good farmer does everything he can to 










THE HEALTH OF THE WORKER 227 

make the work pleasant and to keep the man well and 
happy. In the large factories of cities many men are 
employed, and the managers cannot know every one 
who works for them. In such a case they have a Service 
or Welfare Department, where some well-trained person 
attends to all of the health needs in the factory, making 
plans to promote the health and happiness of the whole 
group of workers. 

The government and the health of the worker. — 

We have been interested in a study of what our govern¬ 
ment does for us. What does it have to do with regulat¬ 
ing factory conditions? 

The government is interested in the welfare of the 
people, and it would be natural to expect it to deal with 
the health of people in industry. Indeed, it does do this, 
and the state government has a group of people, either in 
the State Department of Health or in some other depart¬ 
ment, which looks after the health of workers. 

The state passes laws to prevent injurious conditions in 
industry. Most of the factories in the United States 
maintain conditions which are much better than those 
actually demanded by law. There are always a few 
people in every line of work, however, who either are 
careless or are not considerate of the welfare of people 
about them. It is wise, therefore, for each state to have 
a set of standards in order that no industry may be 
allowed to injure the health of its workers. 

Laws have been passed in most states which prevent 
the employment of people for unreasonably long hours. 


228 


COMMUNITY HEALTH 


The conditions under which women and children are 
allowed to work are often specified by law, because the 
kinds of work which they can do without injury are 
limited. The state laws provide for the inspection of 
factories. Factory inspectors see that the laws are 
obeyed. Factory owners who break the laws are obliged 
to remedy the conditions or they are brought into court 
and punished. 

Accident insurance. — One of the most important 
laws is that which requires every factory to insure all of 
the workers against accident or injury. If a man or 
woman meets with an accident at the factory the in¬ 
surance money will pay for the medical service. If 
the person is kept away from work for more than ten 
days or two weeks he is paid a part of his regular wages. 
If he should meet with a serious accident, such as the 
loss of a hand, the insurance company pays him a large 
sum. 

Of course no insurance can make up for a serious ac¬ 
cident, but it is a valuable aid. The idea of insurance is 
fair, too. You might say that it is partly a man’s fault 
if he has an accident; but he should not bear all the 
cost as well as the pain. Accidents are not intentional. 
A few are bound to occur in any industry. If people are 
going to be hurt in making some product, why should 
not the cost of those accidents be added to the price of 
the product? That is indirectly what happens when 
industries take out accident insurance for their em¬ 
ployees. Some one must look out for a workman and his 


THE HEALTH OF THE WORKER 


229 


family if he has been in an accident and has no money. 
It is much better that it should be done by insurance 
than in any other way. 

The job and the man. — We have seen that the person 
who wants to take care of his health will consider that 
when he picks out a job. The occupation you select is 
very important, because in it you will spend many 
hours a day. Choose carefully and wisely and, once you 
have chosen, plan to maintain health, secure recreation, 
and be worthy of advancement in order that you may 
increase your service to others. 

Questions and Projects 

1. Can you now answer the questions at the beginning of this 

chapter? 

2. Perhaps you can visit a factory in your vicinity and discuss in 

class the kinds of work which you see there and their rela¬ 
tion to health. 

3. Discuss various occupations in class. 

4. What is your father’s work, and what are the health problems 

involved? 

5. Select two or three different occupations and make a list of the 

healthful and unhealthful conditions in connection with 
each. 

6. Write to the State Department of Health for the rules and 

regulations of your state governing factory sanitation and 
the health of the worker. 


APPENDIX 


This Appendix suggests some procedures which have been 
found useful in junior high schools. 

WEIGHING AND MEASURING 

All weighing and measuring should be done carefully and 
accurately. Weighing should be done once a month — if 
possible, always at about the same time of day. Height should 
be taken at least twice during the school year — at the begin¬ 
ning and in January or February. It is desirable that the 
student be weighed and measured without shoes. 

Weighing. — Before weighing, the scales should be tested 
for balance by pushing the balance weights back to zero. 
When the scales are found to vary somewhat from an accurate 
balance, they should be adjusted by the Sealer of Weights and 
Measures or by the teacher. If the scales are moved from one 
room to another, care should be taken to keep the platform 
relatively horizontal, so that the adjustment of the mechanism 
under the platform is not disturbed. The student being 
weighed should stand quietly in the middle of the platform with 
his hands at his sides. 

Measuring. — Two instruments are necessary for measur¬ 
ing: (i) an accurate scale against which the person will stand 
to be measured; and (2) a leveling device which can be placed 
on his head to secure a right-angle measurement against the 
scale. 

One of the best measuring scales is made of inextensible and 
unshrinkable paper, which may be tacked or pasted to a wall 

230 


APPENDIX 


231 


or specially prepared board. It can be secured from the 
American Child Health Association, 370 Seventh Avenue, 
New York City. You may use yardsticks fastened one above 
another on a smooth wall, or a tape measure tacked to the 
wall. Be careful to have them accurately placed. Such a 
scale should be checked by a standard steel tape. 

The leveling device may be made of two pieces of seasoned 
walnut board about seven by five inches. On the inside of the 
median line is a narrow strip with an opening which serves as 
a handle. If such a measuring device cannot be secured con¬ 
veniently, a box with a square edge may be used. (A chalk 
box serves the purpose very well.) The flat surface of a book 
or board cannot be used accurately, because one cannot be 
sure that it will always make a right angle with the scale on 
the wall. 

The person being measured should stand as tall as possible, 
with heels together and with his back and head against the 
wall where the scale is placed. His arms should be at his side, 
and his eyes straight ahead. 

Records. — It is well to keep two sets of records — one on a 
classroom weight-record sheet and another on individual weight 
cards. A regular form of “ Classroom Weight Record ” can 
be secured from the Bureau of Education, Department of the 
Interior, Washington, D.C. The classroom record should be 
kept hanging where students can refer to it — in the home 
room, the hygiene classroom, or the gymnasium. The indi¬ 
vidual cards may be carried home at regular periods to be 
signed by the parent. Both records should give height, weight, 
and average weight for height and age. 

It is desirable that junior high school students should have as 
large a share as possible in the weighing and measuring ac- 


232 


COMMUNITY HEALTH 



tivities. Certain ones can be trained to do the weighing, others 
to do the measuring. Each student can estimate the average 
for his height and age, and take part in keeping his own records, 
recording the figures on his own card or on the classroom weight 
record at the time he is weighed. It will be necessary for the 
teacher to supervise these activities. 

Importance of weighing. — It is desirable that one should be 
within the zone of normal weight — between io per cent below 
average and 20 per cent above. (See Weight-Height-Age 
tables at end of Appendix.) It is more important, however, 
that one should be growing regularly than that one should 
conform exactly to average weight for his height and age. Boys 
and girls of junior high school age should gain from one-half 
to one pound per month. 





























































APPENDIX 


233 


After being weighed, each student should know his actual 
weight and how much he gained or lost. He should be expected 
to have an intelligent understanding of the relation of his 
health habits to his gain or loss in weight. Failure to gain for 
a month or two is not a serious matter, but the student who 
fails to gain should consider his daily habits carefully and cor¬ 
rect those which are faulty. If he fails to gain over a period of 
three months or more, he should receive individual attention. 

DIRECTIONS FOR MAKING A WEIGHT GRAPH 

Use paper which is already “ squared ” for graphs, or rule a 
sheet of drawing paper for the purpose. The horizontal lines 
will represent “ pounds of weight.” The vertical lines will 
represent the “ months ” or the times at which weighings are 
made. 

Each horizontal line should be marked with a figure to show 
the number of pounds, but the numbers will be different for 
each student because the weights are different. Answer these 
questions before you plan your graph: What is your actual 
weight for the first month which you are recording on your 
graph? What is the average weight for your height and age 
at that time? Are you overweight or underweight? 

If you are underweight, let the fifth horizontal line from the 
foot of the graph be marked with the number of pounds which 
represents your actual weight. Each horizontal line below 
should be marked one pound lower and each line above should 
be marked one pound higher. 

If you are overweight, let the fifth horizontal line from the 
foot of the graph be marked with the number of pounds which 
represents the average weight for your height and age. Mark 
your lines above and below as directed. 


234 


COMMUNITY HEALTH 


The vertical lines should be marked with the names of the 
months. On these lines dots are placed to indicate weight at 
weighing periods. The solid black line drawn between these 

dots makes a weight line, which 
falls when you are losing weight 
and rises when you are gaining. 

You can draw a light pencil 
line to represent your expected 
gain if you wish. Find out how 
much a student of your age 
should gain each month, and 
draw from the first dot, which 
represents your actual weight, 
a line which will show the ex¬ 
pected gain per month. 

At the time of your first 
weighing you should be meas¬ 
ured and learn the average 
weight for your height and age. 
The average weight on your 
graph may be represented in 
red. Place a red dot on the 
proper month line to indicate the average weight for your 
height and age. If you wish to draw a line from this across 
the graph, you may draw it on the basis of your expected 
gain per month, just as you drew your line of expected gain 
from the dot which showed your actual weight. You may 
prefer to postpone drawing a line of average weight until 
you are measured again and find your average weight for 
the new height. You can then locate a second red dot on the 
chart, and draw a line connecting the two. 












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WEIGHT GRAPH OF A GIRL 
WHO CAME UP TO WEIGHT 
































































APPENDIX 


235 


It is possible to make various modifications in weight graphs. 
Use any form which helps you to watch your growth in an 
interesting way. 

BOARD OF HEALTH ORGANIZATION 

During this year when your class is studying community 
health, you may find it interesting to undertake some of your 
familiar health activities under a community organization, 
with a Health Officer and a Board of Health. Most communi¬ 
ties have a Board of Health, or some group which corresponds 
to it, to draw up the health ordinances of the town or city 
and establish the general policies of the work. The Health 
Officer or Chairman of the Board of Health, as the case may be, 
is the executive officer and is responsible for the enforcement 
of the health ordinances as set by the Board. 

Under your Health Officer some of you may serve as com¬ 
missioners in charge of various activities. Here are some sugges¬ 
tions for such offices: a commissioner of weights and measures, 
who shall have general charge of whatever weighing and meas¬ 
uring activities are turned over to your class by the teacher; 
an inspection commissioner to direct the inspections; a housing 
commissioner to see that desks and chairs are properly ad¬ 
justed; a safety commissioner to have charge of traffic in halls, 
on stairways, or at the street crossing in front of the school; a 
food commissioner to have charge of milk and crackers at recess; 
a water commissioner to be responsible for the proper use of 
bubblers and for the cleanliness of sinks; a commissioner on 
waste disposal to assist in securing high standards of cleanliness 
in toilets and lavatories. You will think of other divisions of 
work, perhaps, which your teacher will allow you to undertake, 
or in which you can assist her by your classroom organization. 


236 


COMMUNITY HEALTH 


Class meetings may be held under the leadership of the 
Health Officer, and activities for checking and improving in¬ 
dividual health habits may be followed somewhat as in Health 
Club organization. For example, the Commissioner on 
Weights and Measures, with the assistance of a committee, 
may prepare a report for the class on the gains in weight at 
the last weighing, with brief speeches in regard to the most 
important aids in gaining weight or the most common causes 
of losing weight. The Safety Commissioner, with the help of 
a committee, may present a safety play at a meeting of the 
health class. Other programs will suggest themselves. 

The organization of the class is of little importance unless 
it actually helps to produce better habits and improved health 
among the pupils. The Health Officer takes pride in a healthy 
community. Is the health of your class worthy of just pride? 

THE MODERN ‘HEALTH CRUSADE 

The Modern Health Crusade is a device for class organiza¬ 
tion which has been developed by the National Tuberculosis 
Association and used by thousands of schools. Forms and 
blanks for carrying on the Crusade may be secured from your 
local or state Tuberculosis Association. 

Under the Health Crusade plan, honors are given when 
you make a certain score in the keeping of health habits. 
These honors are as follows: Page, Squire, Knight, Knight 
Banneret, Knight Banneret Constant, and Knight of the 
Round Table. 

Do not let the use of the Modern Health Crusade take the 
place of weighing and measuring. The Crusade is merely a 
plan to help children to improve their health habits by check¬ 
ing them very carefully over a definite period. 


APPENDIX 


237 


RECORDING HEALTH HABITS 

Instead of keeping a great many records at once, as in the 
Modern Health Crusade, many classes plan their own records. 
Each habit record should be kept for at least a two-week period. 
This sort of record-keeping helps you to watch a few habits 
definitely, and therefore to fix them more firmly. The advan¬ 
tage of keeping records does not lie in the perfection of the 
record itself. This is merely a way of reminding one’s self 
to keep the habits until they are firmly established. The test 
of health habits is shown in your health and your growth. 
Better habits mean better health and development. 

QUESTIONNAIRES 

A very good way for a class to find out how much they are 
“ investing ” in health habits is to check up by means of a 
questionnaire. The following questions suggest some that may 
be included: 

1. What time did you go to bed last night? 

2. What time did you get up this morning? 

3. How many hours of sleep did you have? 

4. Was your window open? 

5. What did you eat for breakfast this morning? 

6. What vegetables did you eat yesterday? 

7. What fruit, either raw or cooked, did you eat yesterday? 

8. What cereal did you eat yesterday? 

9. How many glasses of milk did you drink yesterday? 

10. How much water did you drink yesterday? 

11. How many cups of tea did you drink yesterday? 

12. How many cups of coffee did you drink yesterday? 

13. Did you eat candy between meals yesterday? 

14. How long did you play out of doors yesterday? 


238 


COMMUNITY HEALTH 


15. How many times did you brush your teeth yesterday? 

16. Have you had a full, warm bath during the last week? 

17. Did you have a bowel movement yesterday? 

18. What health habits have you improved during the past 

year? 

You may prefer to make a questionnaire of your own. You 
may change some of these questions or add others to the 
list. Each one should answer the questionnaire frankly, telling 
exactly what he did, not what he knows he should have done; 
and then the answers should be scored. It is not necessary that 
each one should write out the questions on paper. They can 
be written on the blackboard, arranged in order, with each 
question numbered. The answers should be numbered in the 
same way on paper. 

The answers to the questionnaire should relate to what each 
one did yesterday and this morning; they should not be made 
on the basis of what one usually does. 

After each pupil has checked his own answers, score each 
question for the class as a whole. What habits are most care¬ 
fully practiced? What habits most need improvement? What 
can be done? 

GENERAL HEALTH SCORE CARD 

In the use of the general health score card, one scores upon 
what he believes to be his actual health condition, and upon 
those habits which he can honestly say are firmly established. 
Score yourself now and record your total score for future refer¬ 
ence. Three months later score yourself again and see whether 
you have made a better score. Can you make a perfect score? 
Determine the average score for your class and see whether 
that improves, too. 


APPENDIX 


239 


HEALTH SCORE CARD FOR BOYS AND GIRLS IN JUNIOR 

HIGH SCHOOL 


I. Signs of Health 


Score 


1. Can you work and play without being more 
than naturally tired at bedtime? 

2. Are you rested when you get up in the 
morning? 

3. Is your appetite for wholesome food good? 

4. Is your weight within 10 per cent below or 20 
per cent above average for your height and 
age? 

5. Have you gained the expected amount for your 

age since-? 

(Let teacher decide period of time.) 

6. Is your posture* good? 

7. Are your feet strong and free from any defect? 

8. Are your muscles strong and firm? 

9. Is your vision either normal or corrected by 
glasses? 

10. Can you hear ordinary conversation at sixteen 
feet? 

11. Is your skin clear? Color good? 

12. Is your hair glossy, but free from excessive oil? 

13. Are your teeth either sound or filled? 

14. Are you free from constantly recurring illness, 
including colds? 

15. Are your nose and throat free from defects, or 
treated in accordance with medical advice? 


Score 


II. Health Practices 

1. Do you drink at least two glasses of milk every 
day? 

2. Do you eat fruit at least once a day? 

3. Do you eat at least one vegetable, other than 
potato, every day? 

4. Do you eat an uncooked vegetable at least three 
times a week? 

5. Do you eat some dark bread every day? 

6. Do you drink at least six glasses of water every 
day? 

7. Do you refrain from using tea and coffee? 

8. Do you eat sweets in moderation and only at the 
end of a meal? 


40 

40 

30 


40 

50 

40 

20 

20 

20 

20 

20 

20 

30 

30 

30 

450 


20 

20 

20 

20 

10 

20 

10 

20 











240 


COMMUNITY HEALTH 


9. Do you eat only at mealtime? (Fruit and milk 
may be excepted.) 

10. Do you eat your meals at a regular time each 
day? 

11. Do you eat slowly and chew your food well? 

12. Do you eat a good breakfast, with either cereal 
or egg as a basis? 

13. Do you have a daily scrub with warm water and 
soap, including at least face, neck, ears, hands 
and arms, and wash your hands regularly before 
meals? 

14. Do you have a daily tonic bath with cold water 
in the morning (either shower, tub, or splashing 
on face, throat, and chest) or a dry rub with 
a rough towel? 

15. Do you take a full warm bath at least twice a 
week? 

16. Do you brush your teeth and gums at least 
twice a day? 

17. Do you clean your linger nails every day and re¬ 
frain from biting them? 

18. Do you average at least ten hours of sleep every 
night? 

19. Do you have a window open? 

20. Do you average at least two hours of outdoor 
exercise every day? 

21. Do you have a bowel movement every day? 

22. Do you try to maintain your best standing and 
sitting posture? 

23. For school and work do you wear shoes with 
low, broad heels? 

24. Do you remove outdoor clothing when you are 
indoors — heavy sweaters, suede jackets, rub¬ 
bers, overshoes? 

25. Do you have a complete physical examination 
by a physician once a year? 

26. Do you have your teeth examined and treated 
by your dentist at least once a year? 

27. Flave you been vaccinated? 

28. Have you been immunized against diphtheria? 
(Negative Schick Test is O.K.) 

Score 

Total Score 


Score 

20 

20 

20 

20 

10 

10 

10 

10 

10 

30 

20 

30 

30 

20 

10 

10 

50 

40 

20 

20 

550 

1000 















APPENDIX 


241 


INSPECTIONS 

Daily inspections help to maintain a high standard of per¬ 
sonal appearance. The inspection may be part of the morning 
routine in the home room or it may be associated with the 
hygiene class or the gymnasium. 

The points of inspection are decided by the class and the 
teacher. The following questions suggest the detail of inspec¬ 
tion. 

1. Are your face, neck, and ears clean? 

2. Have you clean hands and finger nails? 

3. Are your nails smooth at the edge and not bitten? 

4. Are your teeth thoroughly brushed? 

5. Are you dressed properly, without heavy coat or sweater, and 

without rubbers or overshoes? 

6. Are you carrying a clean handkerchief? 

7. Is your hair clean and neat? 

The procedure of inspection may be somewhat as follows: 
The inspection commissioner, with the teacher’s help, rules off 
a place at the board where the scores for each team (each row) 
may be recorded. At the time of inspection the commissioner 
will record the scores. 

Each team elects a captain to inspect them. The captains 
are inspected either by the teacher or by the inspection com¬ 
missioner. They examine the members of their teams for the 
various points of inspection. No team can score unless every 
member of the team passes. 

As the commissioner calls for the reports by teams, the 
captain reports “ Score one ” if every member of his team 
passes the point; if some one has failed to pass, he reports “ No 
score.” 


242 


COMMUNITY HEALTH 


DENTAL SCORE CARD 


Defects 

Deductions 

Kind 

ist 

date 

2nd 

date 

3rd 

date 

Amt. 

ist 

date 

2nd 

date 

3rd 

date 

C 




— 4 




X 




— 10 




X- 




— 0 




D* 




—h 




0 




— 1 




Cr 




— 2 





Total Deductions 


Score, ioo — deduction, ist date = 


Score, ioo — deduction, 2nd date = 


Score, 100 — deduction, 3rd date = 


DENTAL SCORE CARD 

The dental score card shown above is used in the junior 
high schools of Cleveland, Ohio; the description given here is 
taken directly from their Tentative Health Program for Junior 
High School: 

“ The following values for scoring dental defects have been 
developed by the Mouth Hygiene Bureau. When the pupil 


























APPENDIX 


243 


examines his record and finds one or more C’s he should know 
that he has that many carious or decayed teeth. The number 
of C’s should be recorded on the score card under ‘ Defects, 
1st date.’ From a perfect score of 100 points deduct 4 points 
for each carious tooth. To determine the amount to be re¬ 
corded under ‘ Deductions, 1st date,’ the number of C’s should, 
therefore, be multiplied by 4. The X’s indicate the number of 
pathological or infected teeth which require extraction, and 
10 points are deducted for each X. The X- indicates a loose 
tooth and no deduction is made for it; but for D’s, which rep¬ 
resent fillings, a half-point each should be deducted. For each 
O, missing tooth, deduct 1 point, and for each Cr, crown, 2 
points. 

“ During the term, if the dental defects are corrected, the 
total deduction will decrease. The corrections will be indicated 
if examinations are made on second and third dates. Since 
slight deductions are made for fillings and for missing teeth 
the score can never equal 100 points, but each correction will 
raise the score.” 

STUDENT COUNCIL 

If there is a Student Council in your school, it may contrib¬ 
ute a great deal to the health activities. The Board of 
Health organization may be connected with the Student Coun¬ 
cil in some way which permits them to work cooperatively. 
Here are some of the activities which are sometimes carried 
on through the leadership of the Student Council: 

1. Promoting better habits of living through campaigns on health, 

using plays, posters, or four-minute speeches. 

2. Encouraging personal neatness by issuing regular reports on the 

highest class scores for daily inspection. 


244 COMMUNITY HEALTH 

3. Encouraging neatness in handling materials by weekly inspec¬ 

tion of students’ lockers and desks. 

4. Maintaining a high degree of neatness about the building by 

daily inspection of floors, toilet rooms, and playground. 

5. Promoting safety by constant watchfulness through a safety 

committee and through publicity in regard to safety. 

USE OF SCHOOL NEWSPAPER 

Health items are of general interest, and the school news¬ 
paper may contribute valuable assistance in the health pro¬ 
gram by publishing timely information and publicity material. 
Here are some examples of health items for the newspaper: 

1. *A special health column, including information about health, 

illustrated health slogans, and answers to health questions. 

2. News items, including reports on visits to places like the Health 

Department, the State Vaccine Laboratory, or a fresh-air 
camp; reports of surveys made in the school — as, for ex¬ 
ample, a survey of food selection made in the lunch room, of 
types of shoes worn, of sleeping habits; items telling about 
health activities carried on in special departments, such as 
poster making or campaigns for better teeth. 

3. Editorials setting forth the importance of health for success and 

happiness and commenting on the health activities of the 
school. 

BULLETIN BOARD 

If you have bulletin boards you will doubtless be interested 
to display health material from time to time. Here are some 
suggestions: 

1. Health posters and slogans made in the art department. 

2. Clippings from newspapers and magazines. 

3. News of a health campaign or special activity being carried on 

by the students. 


APPENDIX 


245 


HEALTH EDUCATION IN RELATION TO OTHER 
SUBJECTS 

Health is such a far-reaching factor in life that the student 
finds throughout many of his subjects an opportunity to 
broaden his health knowledge. Notice how the history of 
different peoples is associated with health. In geography, 
observe how climatic conditions and natural resources affect 
habits of living, customs, and industries. Social science, or 
civics, emphasizes constantly the importance of personal and 
community health as a prime factor in community life. 

General science gives you basic knowledge. The physical- 
education program contributes directly to the health of the 
students. Is each student profiting to the utmost by taking 
part in all those activities for which he is qualified? You 
should regard your ability in physical education as one measure 
of good development and health. 

Home economics is another subject which directly teaches 
health. Girl students should be appreciative of the opportu¬ 
nity to learn scientific facts about diet and care of the home. 
Is there any chance for boys to be instructed in a knowledge of 
foods and cooking which will aid them in camping? 

HEALTH HABIT OBJECTIVES 

The following list of health habit objectives is adapted from 
the Cleveland Tentative Health Education Program for Junior 
High School . 

Growth and I. To determine one’s weight regularly. 

Health 2. To plan a health-training program of the essential daily 

health habits. 

3. To live within one’s own physical limitations. 


COMMUNITY HEALTH 


246 


Mouth and 
Teeth 


4. To brush the teeth at least twice daily in an approved 
way. 

5. To brush the gums and tongue properly. 

6. To Use a toothbrush of the proper size, shape, and 
stiffness. 

7. To use one’s own toothbrush. 

8. To care for the toothbrush properly. (Rinse thoroughly 
in hot water.) 

9. To refrain from biting hard objects. 

10. To keep all foreign objects out of the mouth (pencils, 
fingers, money, etc.) (See also, Hands) 

11. To refrain from picking the teeth with pins. 

12. To select a diet rich in tooth-building material. 

13. To visit a dentist twice a year. 

14. To refrain from kissing any one on the mouth. 


Posture 

Food and 
Habits of 
Eating 


15. To hold the body in an erect position when standing, 
walking, or sitting. 

16. To acquire a taste for milk, green vegetables, hard dark 
breads, and whole-grain cereals. 

17. To refrain from eating an excess of food. 

18. To include sufficient bulky food in the diet. 

19. To include sufficient hard food in the diet. 

20. To avoid sweets or to eat them rarely and never except 
at the end of a meal. 

21. To limit the amount of protein in the diet. 

22. To choose the most healthful meats. 

23. To avoid eating fried foods. 

24. To avoid food fads (hot-water fad, no-breakfast fad, 
raw-food fad). 

25. To eat a simple warm lunch daily. 

26. To use iodized salt at home (if you live in a goiterous 
district). 

27. To eat a good breakfast each morning. 

28. To refrain from eating between meals, especially heavy 
foods and sweets. 

29. To take the heavy meal at the most healthful time of 
day. 

30. To avoid eating when hurried or excited. 

31. To eat three regular meals a day. 


APPENDIX 


247 


32. To drink plenty of water between meals. 

33. To avoid ice water or drink only small portions. 

34. To drink a glass of water before breakfast. 

35. To use individual cups. 

36. To use drinking fountain properly. (See also, Sanitation) 

37. To drink slowly. 

38. To refrain from using soft drinks, except at meals and 
then rarely. 

39. To take small bites and mouthfuls. 

40. To eat slowly and to chew food well. 

41. To refrain from drinking while food is in the mouth. 

42. To rest before and after eating when possible. (See also, 
Rest ) 

43. To sit properly at the table. 

44. To be calm, cheerful, and polite at the table. 

45. To refrain from talking while food is in the mouth. 

46. To wash hands before handling food or eating. (See 
also, Hands) 

47. To refrain from exchanging food or from eating food 
picked up from the floor, ground, or street. 

48. To wash or peel fruit before eating it. 

49. To wash dishes properly after using them. 

50. To use one’s own napkin. 

51. To refrain from handling other people’s food. 

52. To protect food from dust, flies, and rodents. 

53. To handle and store fresh and prepared food properly. 


Elimination of 
Body Waste 


54. To evacuate the bowels at least once daily at a regular 
time, preferably just after breakfast. 

55. To take sufficient water to aid digestion and elimination. 

56. To take sufficient bulky food to aid elimination. (See 
also, Food) 

57. To take sufficient active exercise each day as an aid to 
elimination. 

58. To use toilets and lavatories in a sanitary way. 

59. To avoid the abuse of cathartics. 


Skin 60. To take a cleansing bath at least twice a week, prefer¬ 

ably daily. 

61. To wash the face, neck, and ears daily with warm water 
and soap. 


248 


COMMUNITY HEALTH 



62. 


63 - 


64. 


65 - 

Hands 

66 . 


67. 


68 . 


69. 


70. 


7 1 * 


72. 


73 - 

Hair 

74- 


75 - 


76. 


77 - 


78. 


79 - 


80. 


81. 


82. 

Fresh Air, 

S 3 - 

Ventilation, 

84. 

and Sunshine 

8 S. 


86. 


87. 


88. 


To rinse and dry the skin thoroughly. 

To use one’s own towel and wash cloth and keep them 
clean. 

To provide skin stimulation in the form of cold bath, 
showers, or cold water on face, neck, and chest, followed 
by a brisk rub, or a dry rub with a rough towel. 

To care for roughness of the skin and chafing due to 
unavoidable exposure. 

To wash hands before eating or handling food. (See 
also, Food) 

To wash hands after using toilet. 

To keep nails short and clean. 

To refrain from biting nails or picking hangnails. 

To refrain from putting fingers into the mouth. (See 
also, Mouth) * 

To prevent or care for hangnails. 

To keep one’s hands clean when giving first aid. 

To use one’s own manicure articles. 

To brush and comb the hair daily. 

To use one’s own comb and brush and to keep them 
clean. 

To have the hair washed at least once in two weeks. 

To dry the hair thoroughly before going out. 

To massage the scalp by brisk brushing or rubbing. 

To keep the hair trimmed or tied so that it does not 
hang in the eyes. 

To prevent dandruff. 

To prevent pediculosis. 

To avoid useless and harmful tonics. 

To sleep with windows open at top and bottom. 

To maintain proper ventilation in rooms over which 
one has control. 

To avoid breathing dry, dusty air. 

To avoid breathing fumes. 

To avoid overcrowded and poorly ventilated places. 

To breathe properly with mouth closed and abdomen 
contracted. 



APPENDIX 


249 


Nose 


Disease 


Sanitation 


89. To get abundant sunshine into the home. 

90. To expose the skin to sunlight (to become tanned but 
not burned). 

91. To work and study in well-ventilated rooms. 

92. To choose outdoor recreation when possible. 

93. To breathe through the nose with the mouth closed. 

94. To blow the nose gently, one nostril at a time. 

95. To use only one’s own handkerchief. 

96. To use a clean handkerchief. 

97. To avoid picking the nose. 

98. To cover coughs and sneezes with a clean handkerchief. 

99. To obey quarantine regulations. 

100. To submit to vaccination against smallpox, typhoid 
fever, and diphtheria. 

101. To keep away from those who are ill with communi¬ 
cable diseases. 

102. To prevent colds. 

103. To treat colds properly. 

104. To be careful during convalescence. 

105. To practice those health habits which will protect 
against tuberculosis infection. 

106. To prevent the spread of skin diseases and infections. 

107. To help keep the schoolroom clean. 

108. To keep work material clean. 

109. To keep one’s desk, shelves, and drawers clean. 

no. To help keep the school grounds, home yards, streets, 
alleys, and also parks and camp sites, clean, 
in. To help maintain sanitary conditions of school and 
other public toilets. 

112. To maintain sanitary conditions of kitchen, bath, and 
bedroom. 

113. To have screen doors shut. 

114. To dispose of household waste and garbage, using 
proper receptacles. 

115. To use the drinking fountain properly. (See also, Food) 

116. To use the telephone properly. 

117. To handle money properly. 

118. To help to prevent the breeding of flies and mosquitoes. 


250 


COMMUNITY HEALTH 


Harmful Sub¬ 
stances 


Sleep and Rest 


Clothing 


119. To refrain from drinking tea and coffee during the 
growth of the body. 

120. To refrain from drinking alcoholic beverages. 

121. To refrain from using any form of tobacco. 

122. To take medicine only according to the doctor’s in¬ 
struction (home remedies excepted). 

123. To have a regular bedtime. 

124. To sleep outdoors or with windows open. 

125. To sleep without artificial light in the room. 

126. To take a relaxed position for sleeping or resting. 

127. To use a low pillow or no pillow. 

128. To use sufficient light warm cover but not too much. 

129. To relax during rest periods at school or at home. 

130. To provide for sufficient rest and relaxation during the 
day. 

131. To rest after eating when possible. (See also, Food) 

132. To eat only light meals before sleeping. 

133. To avoid intense mental activity or excitement just 
before retiring (to have a quiet evening). 

134. To air bed clothing each morning. 

135. To confine parties to one week-end night. 

136. To sleep alone in one’s own bed and in one’s own room 
if possible. 

137. To remove clothing at night. 

138. To sleep in hygienic night clothing. 

139. To change sheets and pillow slips each week. 

140. To choose clothing of suitable size and style, suspended 
from the shoulders. 

141. To have clothing suitably adjusted for comfort and 
vigorous activities (no restraining bands or elastics). 

143. To keep clothing as clean as possible. 

143. To keep shoes clean and polished. 

144. To have clean underclothing and stockings at least 
twice a week (preferably oftener). 

145. To refrain from getting clothing wet if possible, and to 
remove damp clothing as soon as possible and warm 
the body if it has been chilled. 

146. To adjust the amount of clothing worn to the temper¬ 
ature and the weather. 


APPENDIX 


Feet 


Eyes 


251 

147. To remove extra wraps, sweaters, and rubbers when in¬ 
doors. 

148. To avoid waterproofed material for constant wear. 

149. To wear underclothing suitable to climate and season. 

150. To avoid excessive neckwear and furs. 

151. To put on extra, wraps when one is warm after exercise. 

152. To keep wraps and clothing neatly and in a proper 
place. 

153. To remove all clothing at night, spread it to air, and 
put on night clothes. 

154. To select hats that are ventilated and not too tight. 

155. To wear light-colored clothing during the summer. 

156. To wash feet regularly. 

157. To keep the nails short and clean. 

158. To prevent ingrowing toe nails by trimming them 
squarely, scraping thin on top, and wearing proper 
shoes. 

159. To wear stockings of proper size. 

160. To wear shoes of proper size and shape (straight inner 
edge and low, flat heel). 

161. To wear rubbers at appropriate times. 

162. To remove overshoes indoors. 

163. To read only in proper light. 

164. To hold book or handwork in correct position and at 
proper distance from eyes. 

165. To avoid casting a shadow upon one’s writing or hand¬ 
work. 

166. To refrain from looking directly at the sun or extremely 
bright lights (wear eye shade when necessary). 

167. To avoid glare. 

168. To wear dark glasses when glare is unavoidable. 

169. To avoid excess of fine work. 

170. To rest the eyes frequently or when tired by closing 
them or focusing them on distant objects. 

171. To avoid reading while lying down. 

172. To avoid reading on moving cars. 

173. To avoid sitting too close to the screen at the movies. 

174. To avoid reading fine print, blurred letters, etc. 


252 


COMMUNITY HEALTH 


Ears 


Safety 


175. To secure properly fitted glasses when necessary and to 
wear them according to the oculist’s directions. 

176. To have a periodic examination o£ one’s eyes. 

177. To keep frames of glasses properly adjusted (not bent). 

178. To keep the lenses clean. 

179. To refrain from rubbing the eyes, and to keep inap¬ 
propriate articles away from them. 

180. To remove properly any foreign objects from the eyes. 

181. To secure medical advice when there is trouble with 
the eyes. 

182. To bathe the eyes when they are sore or tired. 

183. To wash the ears carefully. 

184. To refrain from putting anything into the ears. 

185. To refrain from shouting into or pulling other people’s 
ears. 

186. To avoid blowing the nose forcibly, in order to prevent 
possible injury to the ears. 

187. To secure medical advice when there is trouble with the 
ears. 

188. To protect the ears when swimming. 

189. To develop practices of safety. 


APPENDIX 

WEIGHT—HEIGHT—AGE TABLE FOR GIRLS 


253 


Height 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

Inches 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

38 

33 

33 













39 

34 

34 













40 

36 

36 

36 












41 

37 

37 

37 












42 

39 

39 

39 












43 

41 

41 

41 

41 











44 

42 

42 

42 

42 











45 

45 

45 

45 

45 

45 










46 

47 

47 

47 

48 

48 










47 

49 

50 

50 

50 

50 

50 









48 


52 

52 

52 

52 

53 

53 








49 


54 

54 

55 

55 

56 

56 








50 


56 

56 

57 

58 

59 

61 

62 







51 



59 

60 

61 

61 

63 

65 







52 



63 

64 

64 

64 

65 

67 







53 



66 

67 

67 

68 

68 

69 

71 






54 




69 

70 

70 

71 

71 

73 






55 




72 

74 

74 

74 

75 

77 

78 





56 





76 

78 

78 

79 

81 

83 





57 





80 

82 

82 

82 

84 

88 

92 




58 






84 

86 

86 

88 

93 

96 

101 



59 






87 

90 

90 

92 

96 

100 

103 

104 


60 






91 

95 

95 

97 

101 

105 

108 

109 

Ill 

61 







99 

100 

101 

105 

108 

112 

113 

116 

62 







104 

105 

106 

109 

113 

115 

117 

118 

63 








110 

110 

112 

116 

117 

119 

120 

64 








114 

115 

117 

119 

120 

122 

123 

65 








118 

120 

121 

122 

123 

125 

126 

66 









124 

124 

125 

128 

129 

130 

67 









128 

130 

131 

133 

133 

135' 

68 









131 

133 

135 

136 

138 

138 

69 










135 

137 

138 

140 

142 

70 










136 

138 

140 

142 

144 

71 










138 

140 

142 

144 

145 


Prepared by Bird T. Baldwin, Ph.D., and Thomas D. Wood . M.D, 


About what a G I R L should gain each month. 

Age Age 

5 yrs. to 8 yrs. 6 oz. 14 yrs to 16 yrs. 8 oz. 

8 “ “ 11 “. 8 “ 16 “ “ 18 “.4 “ 

11 “ “ 14 “. 12 “ ' 

Courtesy of the American Child Health Association 







































































00 Or 


254 


COMMUNITY HEALTH 

WEIGHT—HEIGHT—AGE TABLE FOR BOYS 


Height 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

W 

19 

Inches 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

Yrs. 

38 

34 

34 














39 

35 

35 














40 

36 

36 














41 

38 

38 

38 













42 

39 

39 

39 

39 












43 

41 

41 

41 

41 












44 

44 

44 

44 

44 












45 

46 

46 

46 

46 

46 











46 

47 

48 

48 

48 

48 











47 

49 

50 

50 

50 

50 

50 










48 


52 

53 

53 

53 

53 










49 


55 

55 

55 

55 

55 

55 









50 


57 

58 

58 

58 

58 

58 

58 








51 



61 

61 

61 

61 

61 

61 








52 



63 

64 

64 

64 

64 

64 

64 







53 



66 

67 

67 

67 

67 

68 

68 







54 




70 

70 

70 

70 

71 

71 

72 






55 




72 

72 

73 

73 

74 

74 

74 






56 




75 

76 

77 

77 

77 

78 

78 

80 





57 





79 

80 

81 

81 

82 

83 

83 





58 





83 

84 

84 

85 

85 

86 

87 





59 






87 

88 

89 

89 

90 

90 

90 




60 






91 

92 

92 

93 

94 

95 

96 




61 







95 

90 

97 

99 

100 

103 

106 



62 







100 

101 

102 

103 

104 

107 

111 

116 


63 







105 

106 

107 

108 

110 

113 

118 

123 

127 

64 








109 

111 

113 

115 

117 

121 

126 

130 

65 








114 

117 

118 

120 

122 

127 

131 

134 

66 









119 

122 

125 

128 

132 

136 

139 

67 









124 

128 

130 

134 

136 

139 

142 

68 










134 

134 

137 

141 

143 

147 

69 










137 

139 

143 

14b 

149 

152 

70 










143 

144 

145 

148 

151 

155 

71 










148 

150 

151 

152 

154 

159 

72 











153 

155 

156 

158 

163 

73 











157 

160 

162 

164 

167 

74 











160 

164 

168 

170 

171 


Prepared by Bird T. Baldwin, Ph.D., and Thomas D. Wood, M.D. 

About what a B O Y should gain each month. 


Age Age 

yrs. to 8 yrs .6 oz. 12 yrs. to 16 yrs. 

44 “ 12 44 . 8 “ 16 44 44 18 44 


Courtesy of the American Child Health Association 


16 oz 
8 44 


























































































INDEX 


Accident insurance, 229 
Accidents, 171 
alcohol and, 179 
automobile, 173 
from falling, 178 
from fire, 176 
Adulteration of food, 46 
Air, 126 

Alcohol, 61, 62, 68, 69, 70, 71, 72, 73, 
74 , 75 , 179 
wood, 73 
Algae, 26 

American Child Health Association, 
231 

American Red Cross, 168 
Antitoxin, 116 
Ashes, 77 

Baby, care of, 141 
Bathing beaches, 103 
Beer, 69 

Black Hole of Calcutta, 129 
Bovine tuberculosis, 52 
Bubbler fountains, 39 
Building site, 12 

Bulletin board, health use of, 244 
Bureau of Education, 231 

Camp sanitation, 93 
Carbohydrates, 41 
Carbon monoxide, 222 
Carrier of disease, 58 
Certified milk, 55 
Cesspools, 87 

Child Welfare, Division of, 158 
Chlorination, 34 
City, lighting of, 107 
sanitation of, 94 
water supplies, 30 

Classroom, health activities in, 235 


Cold storage, 59 
Colonial food habits, 43 
Common cold, 131 

Communicable disease, control of, 151 
Community health problems, 22 
Correlations, in health education, 245 
Cottages, sanitation of, 92 
Crops, 14 

Dangerous trades, 222 
Defects, correction of, 203 
Dental hygiene, 144 
Dental score card, 242 
Diet, food substances in, 41 
Diphtheria, no, 116, 119 
Disease, carrier of, 58 
early ideas of, 108 
scientific knowledge of, no 
Domestic animals, care of, 13 
Drinking cups, 39 
Drown, T. M., 82 
Drugs, 61, 62, 75, 76 

Earl, Alice Morse, 43 
Earp, J. R., 63 
Employment, age of, 223 

Factory, sanitation of, 224 
Fatigue, 218 
causes of, 219 
cumulative, 219 
mental, 219 
normal, 218 
Fats, 41 

Federal health work, 167 
Fertilizer, 80 

Filters, intermittent sand, 81 
mechanical, 34 
slow sand, 32 
Fire, accidents from, 176 


255 


INDEX 


256 
Flea, 95 

Fly, control of, 97 
life history of, 97 
Food, 41 

adulteration of, 46 
control of, 57 
sanitation of, 50 
Food and Drug Act, 47, 75 
Food habits, 42 
colonial, 43 
modern, 46 
Food handlers, 58 
Food poisoning, 57 
Food-shops, sanitation of, 58 
Fumigation, 96, 153 

Garbage, 78 

Government, duties of, 19 
health problems of, 20 
nature of, 18 
Growth, 7 
rate of, 140 
records of, 231 

Harrison Narcotic Law, 48, 75 
Health, defined, 3 
how secured, 7 
industrial, 211 
private agencies for, 168 
problems of, 22 
signs of, 6 
value of, 4 
Health clubs, 236 
Health Department, 148 
activities of, 151 
child-welfare work of, 158 
food control in, 157 
nursing in, 158 
organization of, 148 
powers of, 149 
publications in, 160 
sanitation by, 157 
small, 160 
State, 167 
visit to, 164 
vital statistics in, 160 
Health education, 122, 206 
Health habit objectives, 24, 245 
Health habits, recording, 237 
Healfh heroes, 112 


Health inspections, 241 

Health officers, training of, 161 

Health rules, 8 

Health score card, 238 

Height, measurement of, 230 

Height-weight-age tables, 253, 254 

Hospitals, 154 

Hours of labor, 217 

Housing, 104 

Hygeia, 109 

Hygiene, defined, 3 

Ice, 37 , 38 
Ice cream, 59 
Immunization, 115, 121 
Incubation, period of, 152 
Industrial health, 211 
dusts and, 223 

government supervision of, 227 
poisons and, 222 
Infant welfare, 139 

community responsibility for, 145 
Insanity, alcoholic, 74 
Insects, control of, 112 
Inspection, classroom, 241 
meat, 48 

Insurance, accident, 228 
Isolation, 121 

Italian Institute of Hygiene, 3 

Laboratories, public health, 154 
Lawrence Experiment Station, 82 
Lead, poison from, 29, 222 
Life, expectation of, in 

Malaria, 99, no, 112 
parasite of, 112 
Measles, epidemic of, 152 
Meat, inspection of, 48 
Mice, 95 

Milk, certified, 55 
diseases spread through, 52 
for infants, 143 
pasteurization of, 54 
sanitation of, 50 
Mills, H. F., 82 
Minerals, in diet, 42 
Modern Health Crusade, 236 
Mosquito, control of, 99 
life history of, 100 


INDEX 


257 


Motion pictures: Conquering Diph¬ 
theria, 120; Waste Disposal , 89 

National Safety Council, 172 
National Tuberculosis Association, 
168, 236 

New York City, water supply of, 30 
New York Ventilation Commission, 

131 

Nightingale, Florence, 158 
Nuisance, 149 
Nurses, school, 201 
Nursing, 158 

Objectives, health habit, 245 
Occupation, choosing an, 211 
Olympic games, 215 

Panacea, 109 
Parasites, 48, hi 
P arks, 187, 192 
development of, 192 
national, 193 
Pasteurization, 54 
Patent medicines, 75 
Physical education, 205 
Pioneer, crops raised by, 14 
diseases of, 16 
domestic animals of, 13 
health problems of, n 
waste disposal by, 15 
Plague, 95 
Play, 184 

Playgrounds, 187, 191 
Playground and Recreation Associa¬ 
tion of America, 188 
Plymouth, Pennsylvania, typhoid epi¬ 
demic, 89 
Poisons, food, 57 
industrial, 222 

Popular health instruction, 160 
Pork worm, 49 
Proteins, 41 

Public Health Nursing Association, 
168 

Putrefaction, 87 

Quarantine, 121 
Questionnaires, 237 
Quinine, 115 


Rat flea, 95 
Rats, 95 
Recreation, 184 
commercial agencies for, 194 
community responsibility for, 187 
in country and in city, 184 
individual responsibility for, 194 
school equipment for, 189 
Refrigeration, 59 
Rickets, 143 
Rubbish, 77 

Safety, 170 
activities for. 179 
responsibility for, 179 
slogans for, 183 
Sanitarians, training of, 161 
Sanitation, 122, 157 
camp, 93 
food, 50 
rural, 92 

Scarlet fever, 121 
Schools, defect correction in, 203 
doctors in. 201 
health activities in, 197, 198 
health education in, 206 
health promotion in, 204 
health protection in, 200 
nurses in, 201 
sanitation of, 200 
ventilation in, 133 
Score card, 238 
Sedgwick, W. T., 38, 82 
Self-purification of streams, 88 
Sepsis, 87 
Septic tanks, 88 
Serum, 116 

Sewage, disposal of, 78, 79 
farms, 81 
filtration of, 81 
purification in one city, 88 
reasons for disposal, 89 
Sewerage, 78 
Shellfish, 56 
Smallpox, 118 
Springs, safety of, 28 
Sprinkling filter, 86 
Starches, 41 

State health department, 167 
Statistics, 160 


258 


INDEX 


Street cleaning, 107 
Sugars, 41 
Sunlight, 137, 143 
Swimming pools, 103 

Tapeworm, 48 
Teeth, 144 

Ten Commandments of health, 209 
Tobacco, 61, 62, 63, 64, 65, 66, 67, 68 
Toxin, 116 
Trichinella, 49 
Tuberculosis, 223 
bovine, 52 

Typhoid fever, 56, 92, no, 121, 155 
epidemic of, 89 

U. S. Department of Agriculture, 168 
U. S. Department of Labor, 168 
U. S. Department of the Interior, 168 
U. S. Public Health Service, 167 

Vaccination, 118, 121 
Vegetables, sanitation of, 56 
Ventilation, 126 

common cold and, 131 
effects of, 129 
experiment in, 138 
mechanical, 136 
qualities of, 131 
types of, 132 
window, 132 
Vital statistics, 160 
Vitamins, 42 


Water, bacteria of, 28 
city supplies, 30 
color of, 26 

desirable qualities of, 26 
hardness of, 29 
importance of, 24 
in diet, 42 
infected, 32 
iron in, 27 
odor of, 27 
pollution of, 31 
protection of, 36 
purification of, 31 
by chlorine, 34 
by mechanical filter, 34 
by slow sand filter, 32 
by storage, 32 
qualities of, 29 
roily, 27 
safety of, 28 
Wastes, 15 
disposal of, 77 
Weighing, and measuring, 
importance of, 232 
Weight graphs, 233 
Wells, protection of, 36 
safety of, 28 
Wines, 69 

Work, hours of, 217 
conditions of, 224 

Yellow fever, 99 


230 


I 


















t 


















